Advertisement

EUS-FNA of the Esophagus and Mediastinum

  • Amol Bapaye
  • Advay Aher

Abstract

EUS is accurate in identification and evaluation of mediastinal mass lesions. Tissue acquisition of these lesions has always been a challenging task. FNA can be performed under EUS guidance under real-time vision with precise needle control and accurate needle placement inside the tumor. Doppler further improves safety of the procedure. A majority of mediastinal lesions do not require surgery as primary treatment, and therefore EUS helps to prevent an unnecessary thoracotomy in these patients [1, 2].

Keywords

Bronchogenic Cyst Mediastinal Lymphadenopathy Mediastinal Lesion Mediastinal Abscess Mediastinal Cyst 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Savides TJ, Perricone A (2004) Impact of EUS-guided FNA of enlarged mediastinal lymph nodes on subsequent thoracic surgery rates. Gastrointest Endosc 60(3):340–346. doi:S0016510704017092 [pii]PubMedGoogle Scholar
  2. 2.
    Larsen SS, Krasnik M, Vilmann P et al (2002) Endoscopic ultrasound guided biopsy of mediastinal lesions has a major impact on patient management. Thorax 57(2):98–103PubMedCentralPubMedGoogle Scholar
  3. 3.
    von Bartheld MB, Rabe KF, Annema JT (2009) Transaortic EUS-guided FNA in the diagnosis of lung tumors and lymph nodes. Gastrointest Endosc 69(2):345–349. doi:S0016-5107(08)02091-9 [pii] 10.1016/j.gie.2008.06.021Google Scholar
  4. 4.
    Wildi SM, Hoda RS, Fickling W et al (2003) Diagnosis of benign cysts of the mediastinum: the role and risks of EUS and FNA. Gastrointest Endosc 58(3):362–368. doi:S0016510703017358 [pii]PubMedGoogle Scholar
  5. 5.
    Ryan AG, Zamvar V, Roberts SA (2002) Iatrogenic candidal infection of a mediastinal foregut cyst following endoscopic ultrasound-guided fine-needle aspiration. Endoscopy 34(10): 838–839. doi:10.1055/s-2002-34262PubMedGoogle Scholar
  6. 6.
    Wiersema MJ, Vilmann P, Giovannini M et al (1997) Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology 112(4): 1087–1095. doi:S0016508597001546 [pii]PubMedGoogle Scholar
  7. 7.
    Catalano MF, Nayar R, Gress F et al (2002) EUS-guided fine needle aspiration in mediastinal lymphadenopathy of unknown etiology. Gastrointest Endosc 55(7):863–869. doi:S0016510702574836 [pii]PubMedGoogle Scholar
  8. 8.
    Fritscher-Ravens A, Sriram P V, Bobrowski C et al (2000) Mediastinal lymphadenopathy in patients with or without previous malignancy: EUS-FNA-based differential cytodiagnosis in 153 patients. Am J Gastroenterol 95(9):2278–2284. doi:S0002-9270(00)01035-2 [pii] 10.1111/j.1572-0241.2000.02243.xPubMedGoogle Scholar
  9. 9.
    Eloubeidi MA, Cerfolio RJ, Chen VK et al (2005) Endoscopic ultrasound-guided fine needle aspiration of mediastinal lymph node in patients with suspected lung cancer after positron emission tomography and computed tomography scans. Ann Thorac Surg 79(1):263–268. doi:S0003-4975(04)01425-0 [pii] 10.1016/j.athoracsur.2004.06.089PubMedGoogle Scholar
  10. 10.
    Vassallo P, Wernecke K, Roos N et al (1992) Differentiation of benign from malignant superficial lymphadenopathy: the role of high-resolution US. Radiology 183(1):215–220PubMedGoogle Scholar
  11. 11.
    Vassallo P, Edel G, Roos N et al (1993) In-vitro high-resolution ultrasonography of benign and malignant lymph nodes. A sonographic-pathologic correlation. Invest Radiol 28(8): 698–705PubMedGoogle Scholar
  12. 12.
    Ribeiro A, Vazquez-Sequeiros E, Wiersema LM et al (2001) EUS-guided fine-needle aspiration combined with flow cytometry and immunocytochemistry in the diagnosis of lymphoma. Gastrointest Endosc 53(4):485–491. doi:S0016-5107(01)24438-1 [pii] 10.1067/ mge.2001.112841PubMedGoogle Scholar
  13. 13.
    Levy MJ, Jondal ML, Clain J et al (2003) Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNA. Gastrointest Endosc 57(1):101–106. doi:10.1067/mge.2003.49 S0016510703500256 [pii]PubMedGoogle Scholar
  14. 14.
    Song HJ, Park YS, Seo DW et al (2010) Diagnosis of mediastinal tuberculosis by using EUS-guided needle sampling in a geographic region with an intermediate tuberculosis burden. Gastrointest Endosc 71(7):1307–1313. doi:S0016-5107(10)00132-X [pii] 10.1016/j. gie.2010.01.059PubMedGoogle Scholar
  15. 15.
    Puri R, Vilmann P, Sud R et al (2010) Endoscopic ultrasound-guided fine-needle aspiration cytology in the evaluation of suspected tuberculosis in patients with isolated mediastinal lymphadenopathy. Endoscopy 42(6):462–467. doi:10.1055/s-0029-1244133PubMedGoogle Scholar
  16. 16.
    Sriram PVJ, Kaffes AJ, Rajasekhar P et al (2004) EUS features of mediastinal tuberculosis: a PCR based cytodiagnosis by transesophageal EUS-FNA. Gastrointest Endosc 59:AB216Google Scholar
  17. 17.
    Wildi SM, Judson MA, Fraig M et al (2004) Is endosonography guided fine needle aspiration (EUS-FNA) for sarcoidosis as good as we think? Thorax 59(9):794–799. doi:10.1136/ thx.2003.009472 59/9/794 [pii]PubMedCentralPubMedGoogle Scholar
  18. 18.
    Fritscher-Ravens A, Sriram PV, Topalidis T et al (2000) Diagnosing sarcoidosis using endosonography-guided fine-needle aspiration. Chest 118(4):928–935PubMedGoogle Scholar
  19. 19.
    Annema JT, Veselic M, Rabe KF (2005) Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of sarcoidosis. Eur Respir J 25(3):405–409. doi:25/3/405 [pii] 10.1183/09031936.05.00098404PubMedGoogle Scholar
  20. 20.
    Savides TJ (2006) EUS diagnosis of posterior mediastinal masses, lymph nodes, and cysts. In: Hawes R, Fockens P (eds) Endosonography, 1st edn. Elsevier, Philadelphia, pp 85–94Google Scholar
  21. 21.
    Varadarajulu S, Hoffman BJ, Hawes RH et al (2004) EUS-guided FNA of lung masses adjacent to or abutting the esophagus after unrevealing CT-guided biopsy or bronchoscopy. Gastrointest Endosc 60(2):293–297. doi:S0016510704016803 [pii]PubMedGoogle Scholar
  22. 22.
    Macchiarini P, Ostertag H (2004) Uncommon primary mediastinal tumours. Lancet Oncol 5(2):107–118. doi:10.1016/S1470-2045(04)01385-3 S1470204504013853 [pii]PubMedGoogle Scholar
  23. 23.
    McGrath KM, Ballo MS, Jowell PS (2001) Schwannoma of the mediastinum diagnosed by EUS-guided fine needle aspiration. Gastrointest Endosc 53(3):362–365. doi:S0016510701794588 [pii]PubMedGoogle Scholar
  24. 24.
    Ribet ME, Copin MC, Gosselin B (1995) Bronchogenic cysts of the mediastinum. J Thorac Cardiovasc Surg 109(5):1003–1010. doi:S0022-5223(95)70327-6 [pii]PubMedGoogle Scholar
  25. 25.
    Snyder ME, Luck SR, Hernandez R et al (1985) Diagnostic dilemmas of mediastinal cysts. J Pediatr Surg 20(6):810–815. doi:S0022346885001671 [pii]PubMedGoogle Scholar
  26. 26.
    Westerterp M, van den Berg JG, van Lanschot JJ et al (2004) Intramural bronchogenic cysts mimicking solid tumors. Endoscopy 36(12):1119–1122. doi:10.1055/s-2004-826042PubMedGoogle Scholar
  27. 27.
    Eloubeidi MA, Cohn M, Cerfolio RJ et al (2004) Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of foregut duplication cysts: the value of demonstrating detached ciliary tufts in cyst fluid. Cancer 102(4):253–258. doi:10.1002/cncr.20369PubMedGoogle Scholar
  28. 28.
    Fritscher-Ravens A, Schirrow L, Pothmann W et al (2003) Critical care transesophageal endosonography and guided fine-needle aspiration for diagnosis and management of posterior mediastinitis. Crit Care Med 31(1):126–132. doi:10.1097/01.CCM.0000045024.16388.96PubMedGoogle Scholar
  29. 29.
    Kahaleh M, Yoshida C, Kane L et al (2004) EUS drainage of a mediastinal abscess. Gastrointest Endosc 60(1):158–160. doi:S0016510704013100 [pii]PubMedGoogle Scholar
  30. 30.
    Toloza EM, Harpole L, Detterbeck F et al (2003) Invasive staging of non-small cell lung cancer: a review of the current evidence. Chest 123(1 Suppl):157S–166SPubMedGoogle Scholar
  31. 31.
    Annema JT, Veselic M, Rabe KF (2004) Analysis of subcarinal lymph nodes in (suspected) non-small-cell lung cancer after a negative transbronchial needle aspiration — what’s next? A preliminary report. Respiration 71(6):630–634. doi:RES2004071006630 [pii] 10.1159/000081765PubMedGoogle Scholar
  32. 32.
    Hammoud ZT, Anderson RC, Meyers BF et al (1999) The current role of mediastinoscopy in the evaluation of thoracic disease. J Thorac Cardiovasc Surg 118(5):894–899. doi:S002252239900481X [pii]PubMedGoogle Scholar

Copyright information

© Springer 2012

Authors and Affiliations

  1. 1.Department of Digestive Diseases and EndoscopyDeenanath Mangeshkar Hospital and Research CenterErandwane, Pune, MaharashtraIndia

Personalised recommendations