Journal article
Endoscopic ultrasound with tissue sampling is accurate in the diagnosis and subclassification of gastrointestinal spindle cell neoplasms
Endoscopic ultrasound, Vol.6(3), pp.174-180
05/2017
DOI: 10.4103/2303-9027.208173
PMCID: PMC5488520
PMID: 28621294
Abstract
Mesenchymal (spindle cell) neoplasms (SCN) of the gastrointestinal (GI) tract are an important subtype of subepithelial lesions that need subclassification to assess their malignant potential. Reported success rates of accurate subclassification with endoscopic ultrasound (EUS)-guided biopsies are variable. Our goal was to analyze our experience using EUS-guided TruCut biopsy (EUS-TCB) in the majority of patients.
Retrospective analysis in patients who underwent EUS with biopsies for suspected SCN at our tertiary referral center between 2004 and 2013.
A total of 146 patients with suspected SCN underwent EUS with tissue acquisition. Thirteen patients were excluded from analysis because tissue acquisition established a definite diagnosis other than SCN. In the remaining 133 patients, tissue acquisition was diagnostic of SCN in 118 (88.7%) and nondiagnostic in 15 (11.3%). Subclassification based on immunohistochemistry (IHC) was possible in 109 of the 133 cases (81.9%). The final diagnosis was GI stromal tumor in 64, leiomyoma in 39, and schwannoma in 6 cases. The percentage of patients who were subclassified by the various EUS-guided techniques together was 72.18%, and the percentage of patients who were subclassified specifically with EUS-TCB was 61.65%. Tissue specimens that enabled a specific diagnosis based on histological or cytological characteristics in conjunctions with IHC were obtained with EUS core biopsy in 83 (TCB in 82 and ProCore needle biopsy in 1), fine-needle aspiration in 13, mucosal resection in 10, and forceps biopsies (bite-on-bite) in 3 cases.
EUS with endoscopic tissue acquisition is accurate in the diagnosis and subclassification of SCN. In experienced hands, the EUS-TruCut needle is a valuable tool with a high success rate for this indication.
Details
- Title: Subtitle
- Endoscopic ultrasound with tissue sampling is accurate in the diagnosis and subclassification of gastrointestinal spindle cell neoplasms
- Creators
- Dalbir Singh Sandhu - Department of Gastroenterology and Hepatology, University of Iowa Hospital and Clinics, Iowa; MetroHealth Medical Center, Cleveland, OH, USAAdrian N Holm - Department of Gastroenterology and Hepatology, University of Iowa Hospital and Clinics, Iowa, USARami El-Abiad - Department of Gastroenterology and Hepatology, University of Iowa Hospital and Clinics, Iowa, USACarolyn Rysgaard - Department of Gastroenterology and Hepatology, University of Iowa Hospital and Clinics, Iowa, USAChris Jensen - Department of Gastroenterology and Hepatology, University of Iowa Hospital and Clinics, Iowa, USAHenning Gerke - Department of Gastroenterology and Hepatology, University of Iowa Hospital and Clinics, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Endoscopic ultrasound, Vol.6(3), pp.174-180
- DOI
- 10.4103/2303-9027.208173
- PMID
- 28621294
- PMCID
- PMC5488520
- NLM abbreviation
- Endosc Ultrasound
- ISSN
- 2303-9027
- eISSN
- 2226-7190
- Publisher
- China
- Language
- English
- Date published
- 05/2017
- Academic Unit
- Gastroenterology and Hepatology; Pathology; Internal Medicine
- Record Identifier
- 9984047862302771
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