Diagnostic usefulness and challenges in the diagnosis of mesothelioma by endoscopic ultrasound guided fine needle aspiration

Abstract

Malignant mesothelioma is a rare neoplasm. It has been noted in the literature that fine needle aspiration (FNA) is a useful tool for the diagnosis of mesothelioma. However, the differential diagnosis may require use of a battery of immunohistochemical stains. Clinico-radiologic correlation is also crucial. Real time endoscopic ultrasound (EUS) combined with FNA has been shown to be a very sensitive technique to obtain samples from different organ sites, including mediastinal lesions. The use of EUS-FNA for the diagnosis of mesothelioma, reinforces the role of a cytopathologist as a cohesive team player along with a radiologist and a clinician during on-site assessment for the proper triage of additional specimens for ancillary studies leading to a better patient management.

Diagnosis of metastatic fibrolamellar hepatocellular carcinoma by endoscopic ultrasound-guided fine needle aspiration

“…Use of a practical algorithm for mediastinal lesions, previously described by Bakdounes et al ., is helpful for arriving at a diagnosis. [11]…”

Fine-Needle Aspiration Biopsies for Gene Expression Ratio-Based Diagnostic and Prognostic Tests in Malignant Pleural Mesothelioma

“…Although MPM is a relatively rare disease with an annual incidence in the US of 2,000 to 3,000 cases, a continuing rise in its incidence has been reported world-wide, presumably due to the continuing unabated use of asbestos in most countries as well as to the long lag period between exposure and presentation (1, 2). Making the correct histological diagnosis of MPM is occasionally challenging and requires structural evaluation and complex immunohistochemical panels (3). These difficulties are a particular problem for fine needle aspiration (FNA) biopsies, necessitating open surgical biopsies in the majority of patients prior to definitive diagnosis (4).…”