Abstract
Background and Study Aims: Diagnosis of submucosal lesions, pancreatic tumors, and mediastinal or celiac lymph
nodes or masses is possible using endoscopic ultrasonography (EUS), but histological
confirmation to differentiate between benign and malignant lesions is still required.
The aim of this study was to evaluate the efficacy of a new method of EUS-guided fine-needle
aspiration biopsy of intramural and paramural lesions.
Patients and Methods: From October 1991 to September 1994, EUS-guided fine-needle aspiration biopsy was
carried out in 141 patients with findings of mediastinal masses (18 cases), mediastinal
lymph nodes (24 cases), submucosal tumors (seven cases), celiac lymph nodes (26 cases),
large gastric folds with negative endoscopic biopsy (13 cases), pancreatic tumors
(43 cases), a small liver metastasis (five cases), retrorectal tumors (four cases),and
an adrenal metastasis (one case). The EUS examination was performed using a Pentax-Hitachi
FG 32-UA system.
Results: A malignant tumor was diagnosed in 110 of the 141 patients. EUS-guided fine-needle
aspiration was positive in 85 cases. In 15 cases, an adequate specimen could not be
obtained (10.6 %). The sensitivity and specificity of the diagnosis of malignancy
were 77.0 % and 100 %, respectively. Results were better for mediastinal masses (sensitivity
88 %), mediastinal lymph nodes (81 %), and celiac lymph nodes (80 %) than for pancreatic
tumors (75 %) or submucosal tumors (60 %).
Conclusions: These results suggest that EUS-guided fine-needle biopsy using a curved-array transducer
represents a step forward in the tissue diagnosis of gastrointestinal lesions.
