Endoscopy 2019; 51(04): S222-S223
DOI: 10.1055/s-0039-1681835
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Endoscopic ultrasound ePosters
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC ULTRASOUND GUIDED LEFT LOBE LIVER LESIONS BIOPSY (EUS-LLB) WITH ATYPICAL MALIGNANCIES, AN ALTERNATIVE APPROACH TO RADIOLOGICAL IMAGE GUIDED BIOPSY

A Urrehman
1   Hepatogastroenterology, Sindh Institute of Urology and Transplantation SIUT, Karachi, Pakistan
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

EUS is gaining attraction as an alternative method of biopsy. It offers a more targeted approach for focal lesions in liver especially those areas which are accessible via EUS-guided method.

Methods:

A total of 7 patients from Feb 2018 till September 2018 underwent EUS-guided Left Lobe lesions biopsies using 22G FNA needle, 2 passes were done with slow pull technique over one minute with 10 – 15 strokes in each pass to obtained core samples. Duration of procedures ranges from 15 – 30 minutes.

Results:

Case 1: 78 male with history of gastrectomy 5 years back for gastric cancer, presented with weight loss and vague epigastric pain, CT scan showed left lobe lesion. Biopsy showed well differentiated Adenocarcinoma from GI Tract. Case 2: 58male presented with weight loss and Liver mass on CT Scan. Hepatitis B & C screen was negative with normal AFP levels. Biopsy revealed Sarcomatoid Carcinoma. Case 3: 53 male presented with weight loss and abdominal pain with multiple liver lesions on CT scan. Biopsy revealed Neuroendocrine Tumor. Case 4: 35 male presented with abdominal pain, anti-HCV reactive with normal AFP levels. CT Scan showed liver lesion suggestive of atypical Hepatocellular carcinoma. Biopsy revealed Smooth Muscle Tumor. Case 5: 60 female presented with weight loss, CT scan showed pancreatic malignancy with liver metastasis. Biopsy revealed Metastatic Adenocarcinoma. Case 6: 42 female presented with obstructive jaundice from ampullary Carcinoma. She underwent EUS staging which revealed left lobe lesion. Biopsy revealed Metastatic Adenocarcinoma. Case 7: 32 male presented with weight loss and obstructive jaundice, CT scan showed left lobe malignancy consistent with Cholangiocarcinoma, biopsy revealed Lymphoproliferative disease (Lymphoma).

Conclusions:

EUS-guided LLB is an alternative new technique for biopsy of liver lesions with suspected atypical malignancies. It appears to have higher level of safety and accuracy for targeted lesional biopsies.