ENDOSCOPIC ULTRASOUND GUIDED BIOPSY OF A MEDIASTINAL MASS

Authors

  • Aasim Yusuf
  • Shahid Raza Khalid
  • Qasim Ahmed
  • Zia S Faruqui

Abstract

Endoscopic ultrasound (EUS) now has an established role in the diagnosis, staging and management of cancers of the oesophagus, stomach, pancreato-biliary system and rectum. Recently, a role for EUS in the staging of lung cancers has been proposed. Linear EUS allows fine needle aspiration (FNA), core biopsies and therapeutic manoeuvres such as coeliac plexus block to be performed. We present here the first reported EUS-guided biopsy from Pakistan. A patient with probable bronchogenic carcinoma was referred for assessment of operability. A thoracic CT scan showed subcarinal and aorto-pulmonary recess lymphadenopathy. An EUS-guided FNA was performed, confirming metastatic non-small cell lung cancer and rendering the patient inoperable.

References

Botet JF, Lightdale CJ, Zauber G, Gerdes H, Urmacher C, Brennan MF. Preoperative staging of oesophageal cancer: comparison of endoscopic US and dynamic CT. Radiology 1991;81:419-25.

Rosch T, Lorenz R, Zenker K. Local staging and assessment of resectability in carcinoma of the oesophagus, stomach and duodenum by endoscopic ultrasonography. Gastrointest Endosc 1992;38:460-7.

Suits J, Frazee R, Erickson RA. Endoscopic ultrasound and fine needle aspiration for the evaluation of pancreatic masses. Arch Surg 1999;134(6):639-42;

Wiersema MJ, Wiersema LM. Endosonography-guided celiac plexus neurolysis. Gastrointestinal Endoscopy 1996;44(6):656-62.

Gress F, Schmitt C, Sherman S, Ikenberry S, Lehman G. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol 1999;94(4):900-5.

Wiersema MJ. Endosonography-guided cystoduodenostomy with a therapeutic ultrasound endoscope. Gastrointest Endosc 1996;44:616-7.

Giovannini M, Bernardini D, Seitz JF. Cystogastrostomy entirely performed under endosonography guidance for pancreatic pseudocyst: results in six patients. Gastrointestinal Endoscopy 1998;48(2):200-3.

Hermens FH, Van Engelenburg TC, Visser FJ, Thunnissen FB, Termeer R, Janssen JP. Diagnostic yield of transbronchial histology needle aspiration in patients with mediastinal lymph node enlargement. Respiration. 2003;70(6):631-5.

Janssen J, Johanns W, Greiner L. Clinical value of endoscopic ultrasound-guided transoesophageal fine needle puncture of mediastinal lesions. Dtsch Med Wochenschr 1998;123(47):1402-9.

Snady H. The role of endoscopic ultrasonography in diagnosis, staging and outcomes of gastrointestinal disease. Gastroenterologist 1994;10:91-110.

Gress FG, Hawes RH, Savides TJ, Ikenbery SO, Lehman GA. Endoscopic ultrasound-guided fine-needle aspiration biopsy using linear array and radial scanning endosono-graphy. Gastrointestinal Endoscopy 1997;45(3):243-50.

Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wierseman LM. Endosonography guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology 1997;112:(4)1087-95.

Giovannini M, Seitz JF, Monges G, Perrier H, Rabbia I. Fine needle aspiration cytology guided by endoscopic ultrasonography results in 141 patients. Endoscopy 1995;27(2):171-7.

Chang KJ, Albers CG, Erickson RA, Butler JA, Wuerker RB, Lin F. Endoscopic ultrasound-guided fine needle aspiration of pancreatic carcinoma. Am J Gastro 1994;89(2):263-6.

Chang KJ, Nguyen P, Erickson RA, Durbin TE, Katz KD. The clinical utility of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of pancreatic carcinoma. Gastrointestinal Endoscopy 1997;45(5): 387-93.

Faigel DO, Ginsberg GG, Bentz JS, Gupta PK, Smith DB, Kochman ML. Endoscopic ultrasound-guided real-time fine-needle aspiration biopsy of the pancreas in cancer patients with pancreatic lesions. J Clin Oncol 1997;15(4):1439-4.

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