Endoscopic Ultrasound (EUS) Guided Evaluation of Upper GI Subepithelial Masses: Comparison of Jumbo Forceps Biopsies (JB) and Touch Preparation (TP) with Fine Needle Aspiration (FNA)/Cell Block (CB).
Aparna Mahajan, Rajesh Keswani, Srinadh Komanduri, Xiaoqi Lin, Ritu Nayar. Northwestern University, Chicago, IL
Background: EUS-guided FNA is often performed for diagnosis of GI subepithelial masses. Alternatively, deep JB can be performed using JB forceps. JB is done via tunneling through the mucosa into the submucosa. A TP of JB allows immediate assessment of adequacy. The aim of our study was to compare the performance of EUS guided JB vs. EUS guided FNA in the diagnosis of subepithelial masses in the upper GI tract.
Design: We reviewed pathology reports and clinical information for 44 suspected upper GI subepithelial masses between 1/2006 and 6/2010. JB was performed with a Radial Jaw 4 forceps. FNA was performed with 19-25 gauge needles. On site evaluation (OSE) of adequacy was performed by a cytopathologist for all FNA and JB. Statistical differences of the two techniques were evaluated using Fisher's exact test.
Results: The location of masses was stomach (33), duodenum (8) and esophagus (3).
|No. of Cases||Adequate on "OSE"||CB||IHC on JB/CB||Definitive diagnosis|
|JB/TP||17||15 (88%)||15 (88%)||14 (82%)|
|FNA||14||10 (71%)||11 (80%)||6 (43%)||9 (64%)|
|JB/TP+FNA||13||11 (85%)||8 (62%)||10 (77%)||12 (92%)|