Endoscopic ultrasound guided brush/fine-needle aspiration cytology: A 15-month study

Diagn Cytopathol. 2018 Jun;46(6):461-472. doi: 10.1002/dc.23917. Epub 2018 Mar 5.

Abstract

Background: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become increasingly popular for the diagnosis and staging of gastrointestinal diseases and peri-gastrointestinal lesions. The application of FNA/Brush has dramatically expanded the clinical utility of EUS.

Aims and objective: To evaluate the diagnostic accuracy, study the spectrum of lesions encountered in EUS-FNAC/brush cytology of gastrointestinal and peri-gastrointestinal lesions.

Materials and methods: Total of 124 patients during the period from August 2015 to November 2016 was included in the study. Routine staining was done.

Results: A total of 124 cases were studied with 86% (107 cases) being satisfactory for evaluation. M:F ratio was 1:1.03, mean age of 50.5 years. The most common site was common bile duct (CBD) (37%) followed by lymph node (21%), pancreas (17.7%), esophagus (17%), stomach (3.5%), liver (1.8%), gallbladder (1%), and spleen (1%). In total, 53.4% lesions were benign, in 6.5% atypical cells were seen, 12.1% were suspicious for malignancy, and 28% cases were positive for malignancy. Follow-up was available in 102 cases with cyto-histopathological concordance rate of 90%.

Conclusion: EUS-FNA/Brush is a reliable, sensitive, specific and minimally invasive way to establish a diagnosis. It can be utilized as a pre-operative procedure for the management of many intra-abdominal lesions and prevent unnecessary invasive procedures.

Keywords: brush cytology; common bile duct; endoscopic guided; esophagus; fine-needle aspiration; gastrointestinal tract; liver; lymph node; pancreas; spleen.

Publication types

  • Evaluation Study

MeSH terms

  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / standards*
  • Female
  • Gastrointestinal Neoplasms / pathology*
  • Humans
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity