Factors Associated with Inadequate Tissue Yield in EUS-FNA for Gastric SMT

Suzuki, Takuto; Arai, Makoto; Matsumura, Tomoaki; Arai, Eiji; Hata, Sachio; Maruoka, Daisuke; Tanaka, Takeshi; Nakamoto, Shingo; Imazeki, Fumio; Yokosuka, Osamu

doi:10.5402/2011/619128

Cited by 41 publications

(41 citation statements)

References 24 publications

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“…To overcome these challenges, EUS-FNA is commonly performed to diagnose SEL. However, previous reports demonstrate diagnostic yields of only 60 % to 80 %, with particular difficulty achieving a tissue diagnosis for small lesions 1 2 3 4. The problem is that FNA obtains cellular aspirates that are typically inadequate for immunohistochemical staining, which is often required to reach a definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of single-incision needle-knife biopsy for sampling subepithelial lesions

et al. 2017

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Background and study aims Single-incision needle-knife (SINK) biopsy is a diagnostic method for acquiring tissue samples for subepithelial lesions (SELs). A single linear incision is made in the overlying mucosa and tissue samples are obtained by passing conventional biopsy forceps through the opening and deep into the lesion. The aim of this study was to describe the efficacy and safety of this technique. Patients and methods Consecutive patients who underwent SINK biopsy for an upper gastrointestinal SEL between October 2013 and September 2015 were retrospectively reviewed. Results Forty-nine patients underwent 50 SINK biopsies. Sufficient sampling for a definite pathologic diagnosis was obtained in 42 (86 %) cases, with 91 % (40/44) having sufficient sample to perform immunohistochemistry when deemed clinically relevant. Of the 26 patients with prior non-diagnostic biopsies or FNA, a specific diagnosis was obtained in 85 % (22/26). There were no significant adverse events. Conclusions SINK biopsy is a safe and feasible strategy for obtaining a definitive tissue diagnosis with immunohistochemistry for SELs.

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Section: Discussionmentioning

confidence: 99%

Efficacy of single-incision needle-knife biopsy for sampling subepithelial lesions

et al. 2017

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“…The definitive cytological and/or histological verification of larger gastric GIST is currently achieved in 50%-70% of EUS-guided fineneedle aspiration (FNA) or EUS-guided Trucut punch biopsies [10][11][12][13][14][15] . The histological diagnosis of GIST requires immunohistochemical detection of CD117 and particularly in CD117-negative tumors of DOG1 with the corresponding histomorphological findings.…”

Section: Eus and Eus-fnamentioning

confidence: 99%

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

Scherübl

Faiss

Knoefel

et al. 2014

WJGE

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Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. Approximately two thirds of clinically manifest tumors occur in the stomach, nearly one third in the small bowel, and the rest in the colorectal region with a few cases in the esophagus. GIST originate within the smooth muscle layer in the wall of the tubular gastrointestinal tract and grow mostly toward the serosa, far less often toward the mucosa. In the latter case, ulceration may develop and can cause gastrointestinal bleeding as the cardinal symptom. However, most GIST of the stomach are asymptomatic. They are increasingly detected incidentally as small intramural or submucosal tumors during endoscopy and particularly during endoscopic ultrasound. Epidemiological and molecular genetic findings suggest that early asymptomatic GIST of the stomach (< 1 cm) show self-limiting tumorigenesis. Thus, early (< 1 cm) asymptomatic gastric GIST (synonym: micro-GIST) are found in 20%-30% of the elderly. The mostly elderly people with early gastric GIST have an excellent GIST-specific prognosis. Patients with early GIST of the stomach can therefore be managed by endoscopic surveillance.

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“…EUS-FNA is one of the easiest and safest methods to obtain pathological samples for SMTs' diagnosis [9][10][11][12]. However, the diagnosis rate of EUS-FNA is insufficient (about 63%) as the obtained samples are too small to pathologically diagnose the mitotic counts [13].…”

Section: Discussionmentioning

confidence: 99%

Open Biopsy guided by Endoscopic Ultrasonography from a Gastric Submucosal Tumor growing Outside the Stomach

Mori

Kobara

Nishiyama

et al. 2015

JGLD

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Submucosal tunneling bloc biopsy for submucosal tumors growing inside the gastric wall is a safe and reliable method. However, it is difficult for an endoscopist to perform submucosal tunneling bloc biopsy and detect the demarcation line between the proper muscular layer and the capsule layer of submucosal tumors growing outside the gastric wall.A submucosal tumor in the lesser curvature of the stomach was identified in a 74-year-old man by esophagogastroduodenoscopy. Computed tomography revealed hetero-density with partial calcification of the tumor growing outside the gastric wall, that connected to approximately 10 mm of the muscular layer. Almost all of the tumor body was located outside the stomach. After the small connecting area was detected by endoscopic ultrasonography, two markings were placed at the opposite ends of the tumor. The tumor was removed via snare resection between the markings located immediately above the top of the tumor. After the biopsy site was reconfirmed using endoscopic ultrasonography, a large bloc biopsy was conducted. This new "open biopsy under endoscopic ultrasonography" is a simple, safe, and reliable method to obtain samples from any type of submucosal tumor growing inside or outside the stomach.

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Factors Associated with Inadequate Tissue Yield in EUS-FNA for Gastric SMT

Cited by 41 publications

References 24 publications

Efficacy of single-incision needle-knife biopsy for sampling subepithelial lesions

Efficacy of single-incision needle-knife biopsy for sampling subepithelial lesions

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

Open Biopsy guided by Endoscopic Ultrasonography from a Gastric Submucosal Tumor growing Outside the Stomach

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