Endoscopic ultrasound-guided Trucut biopsy of gastrointestinal mesenchymal tumor

John DeWitt, Robert Emerson, Stuart Sherman, Mohammad Al-Haddad, Lee McHenry, Gregory A. Cote, Julia K. Leblanc

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Data on the utility of endoscopic ultrasound-guided Trucut biopsy (EUS-TCB) for suspected gastrointestinal mesenchymal tumor (GIMT) are limited. This study aimed to determine the diagnostic yield and complications from EUS-TCB for GIMT. Methods: Consecutive patients with suspected upper gastrointestinal or rectal GIMT from the muscularis propria with a maximal diameter of 20 mm or more were enrolled in a prospective, single-center cohort. An EUS-TCB was performed when on-site fine-needle aspiration (FNA) cytology review of the lesion was deemed suboptimal. Gastrointestinal stromal tumor (GIST) and leiomyoma were defined by the presence or absence of positive immunochemistry (IC) for c-kit, respectively. All GIMTs with a nondiagnostic IC were considered as unspecified. The outcomes assessed included diagnostic pathologic and IC yield (when tested) and procedural complications. Results: In this study, 38 patients (24 women; median age, 62 years) with suspected GIMT (median maximal diameter, 42 mm; range, 20-120 mm) in the esophagus (n = 6), stomach (n = 28), duodenum (n = 3), or rectum (n = 1) underwent EUS-TCB without complications. Final diagnoses included GIST for 20 patients, leiomyoma for 13 patients, unspecified GIMT for 3 patients, and unknown disorder for 2 patients. An EUS-FNA was performed for 33 (87%) of the 38 patients, a diagnostic final cytology for 25 (76%) of 33 patients, and an FNA-IC for 12 (50%) of 24 patients. The EUS-TCB (median, 3 passes; range, 1-8 passes) obtained a visible tissue specimen in 37 (97%) of the 38 patients, with a median overall maximal fragment length of 3.5 mm (range, 0-15 mm). The diagnostic final TCB histology and TCB-IC were obtained, respectively, in 79 and 97% of the samples tested. Conclusions: In this cohort, EUS-TCB provided diagnostic histology and IC for 79 and 97% of the patients, respectively. For the initial biopsy of GIMT, EUS-TCB may be considered an acceptable alternative to EUS-FNA.

Original languageEnglish
Pages (from-to)2192-2202
Number of pages11
JournalSurgical Endoscopy and Other Interventional Techniques
Volume25
Issue number7
DOIs
StatePublished - Jul 2011

Fingerprint

Immunochemistry
Biopsy
Neoplasms
Fine Needle Biopsy
Gastrointestinal Stromal Tumors
Leiomyoma
Cell Biology
Histology
Duodenum
Rectum
Esophagus
Stomach

Keywords

  • Endoscopic ultrasound
  • Gastrointestinal stromal tumor
  • Leiomyoma
  • Submucosal mass
  • Tissue sampling
  • Trucut biopsy

ASJC Scopus subject areas

  • Surgery

Cite this

Endoscopic ultrasound-guided Trucut biopsy of gastrointestinal mesenchymal tumor. / DeWitt, John; Emerson, Robert; Sherman, Stuart; Al-Haddad, Mohammad; McHenry, Lee; Cote, Gregory A.; Leblanc, Julia K.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 25, No. 7, 07.2011, p. 2192-2202.

Research output: Contribution to journalArticle

@article{fd3f68e69d604df990ab45245a0995e0,
title = "Endoscopic ultrasound-guided Trucut biopsy of gastrointestinal mesenchymal tumor",
abstract = "Background: Data on the utility of endoscopic ultrasound-guided Trucut biopsy (EUS-TCB) for suspected gastrointestinal mesenchymal tumor (GIMT) are limited. This study aimed to determine the diagnostic yield and complications from EUS-TCB for GIMT. Methods: Consecutive patients with suspected upper gastrointestinal or rectal GIMT from the muscularis propria with a maximal diameter of 20 mm or more were enrolled in a prospective, single-center cohort. An EUS-TCB was performed when on-site fine-needle aspiration (FNA) cytology review of the lesion was deemed suboptimal. Gastrointestinal stromal tumor (GIST) and leiomyoma were defined by the presence or absence of positive immunochemistry (IC) for c-kit, respectively. All GIMTs with a nondiagnostic IC were considered as unspecified. The outcomes assessed included diagnostic pathologic and IC yield (when tested) and procedural complications. Results: In this study, 38 patients (24 women; median age, 62 years) with suspected GIMT (median maximal diameter, 42 mm; range, 20-120 mm) in the esophagus (n = 6), stomach (n = 28), duodenum (n = 3), or rectum (n = 1) underwent EUS-TCB without complications. Final diagnoses included GIST for 20 patients, leiomyoma for 13 patients, unspecified GIMT for 3 patients, and unknown disorder for 2 patients. An EUS-FNA was performed for 33 (87{\%}) of the 38 patients, a diagnostic final cytology for 25 (76{\%}) of 33 patients, and an FNA-IC for 12 (50{\%}) of 24 patients. The EUS-TCB (median, 3 passes; range, 1-8 passes) obtained a visible tissue specimen in 37 (97{\%}) of the 38 patients, with a median overall maximal fragment length of 3.5 mm (range, 0-15 mm). The diagnostic final TCB histology and TCB-IC were obtained, respectively, in 79 and 97{\%} of the samples tested. Conclusions: In this cohort, EUS-TCB provided diagnostic histology and IC for 79 and 97{\%} of the patients, respectively. For the initial biopsy of GIMT, EUS-TCB may be considered an acceptable alternative to EUS-FNA.",
keywords = "Endoscopic ultrasound, Gastrointestinal stromal tumor, Leiomyoma, Submucosal mass, Tissue sampling, Trucut biopsy",
author = "John DeWitt and Robert Emerson and Stuart Sherman and Mohammad Al-Haddad and Lee McHenry and Cote, {Gregory A.} and Leblanc, {Julia K.}",
year = "2011",
month = "7",
doi = "10.1007/s00464-010-1522-z",
language = "English",
volume = "25",
pages = "2192--2202",
journal = "Surgical Endoscopy",
issn = "0930-2794",
publisher = "Springer New York",
number = "7",

}

TY - JOUR

T1 - Endoscopic ultrasound-guided Trucut biopsy of gastrointestinal mesenchymal tumor

AU - DeWitt, John

AU - Emerson, Robert

AU - Sherman, Stuart

AU - Al-Haddad, Mohammad

AU - McHenry, Lee

AU - Cote, Gregory A.

AU - Leblanc, Julia K.

PY - 2011/7

Y1 - 2011/7

N2 - Background: Data on the utility of endoscopic ultrasound-guided Trucut biopsy (EUS-TCB) for suspected gastrointestinal mesenchymal tumor (GIMT) are limited. This study aimed to determine the diagnostic yield and complications from EUS-TCB for GIMT. Methods: Consecutive patients with suspected upper gastrointestinal or rectal GIMT from the muscularis propria with a maximal diameter of 20 mm or more were enrolled in a prospective, single-center cohort. An EUS-TCB was performed when on-site fine-needle aspiration (FNA) cytology review of the lesion was deemed suboptimal. Gastrointestinal stromal tumor (GIST) and leiomyoma were defined by the presence or absence of positive immunochemistry (IC) for c-kit, respectively. All GIMTs with a nondiagnostic IC were considered as unspecified. The outcomes assessed included diagnostic pathologic and IC yield (when tested) and procedural complications. Results: In this study, 38 patients (24 women; median age, 62 years) with suspected GIMT (median maximal diameter, 42 mm; range, 20-120 mm) in the esophagus (n = 6), stomach (n = 28), duodenum (n = 3), or rectum (n = 1) underwent EUS-TCB without complications. Final diagnoses included GIST for 20 patients, leiomyoma for 13 patients, unspecified GIMT for 3 patients, and unknown disorder for 2 patients. An EUS-FNA was performed for 33 (87%) of the 38 patients, a diagnostic final cytology for 25 (76%) of 33 patients, and an FNA-IC for 12 (50%) of 24 patients. The EUS-TCB (median, 3 passes; range, 1-8 passes) obtained a visible tissue specimen in 37 (97%) of the 38 patients, with a median overall maximal fragment length of 3.5 mm (range, 0-15 mm). The diagnostic final TCB histology and TCB-IC were obtained, respectively, in 79 and 97% of the samples tested. Conclusions: In this cohort, EUS-TCB provided diagnostic histology and IC for 79 and 97% of the patients, respectively. For the initial biopsy of GIMT, EUS-TCB may be considered an acceptable alternative to EUS-FNA.

AB - Background: Data on the utility of endoscopic ultrasound-guided Trucut biopsy (EUS-TCB) for suspected gastrointestinal mesenchymal tumor (GIMT) are limited. This study aimed to determine the diagnostic yield and complications from EUS-TCB for GIMT. Methods: Consecutive patients with suspected upper gastrointestinal or rectal GIMT from the muscularis propria with a maximal diameter of 20 mm or more were enrolled in a prospective, single-center cohort. An EUS-TCB was performed when on-site fine-needle aspiration (FNA) cytology review of the lesion was deemed suboptimal. Gastrointestinal stromal tumor (GIST) and leiomyoma were defined by the presence or absence of positive immunochemistry (IC) for c-kit, respectively. All GIMTs with a nondiagnostic IC were considered as unspecified. The outcomes assessed included diagnostic pathologic and IC yield (when tested) and procedural complications. Results: In this study, 38 patients (24 women; median age, 62 years) with suspected GIMT (median maximal diameter, 42 mm; range, 20-120 mm) in the esophagus (n = 6), stomach (n = 28), duodenum (n = 3), or rectum (n = 1) underwent EUS-TCB without complications. Final diagnoses included GIST for 20 patients, leiomyoma for 13 patients, unspecified GIMT for 3 patients, and unknown disorder for 2 patients. An EUS-FNA was performed for 33 (87%) of the 38 patients, a diagnostic final cytology for 25 (76%) of 33 patients, and an FNA-IC for 12 (50%) of 24 patients. The EUS-TCB (median, 3 passes; range, 1-8 passes) obtained a visible tissue specimen in 37 (97%) of the 38 patients, with a median overall maximal fragment length of 3.5 mm (range, 0-15 mm). The diagnostic final TCB histology and TCB-IC were obtained, respectively, in 79 and 97% of the samples tested. Conclusions: In this cohort, EUS-TCB provided diagnostic histology and IC for 79 and 97% of the patients, respectively. For the initial biopsy of GIMT, EUS-TCB may be considered an acceptable alternative to EUS-FNA.

KW - Endoscopic ultrasound

KW - Gastrointestinal stromal tumor

KW - Leiomyoma

KW - Submucosal mass

KW - Tissue sampling

KW - Trucut biopsy

UR - http://www.scopus.com/inward/record.url?scp=79960406162&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960406162&partnerID=8YFLogxK

U2 - 10.1007/s00464-010-1522-z

DO - 10.1007/s00464-010-1522-z

M3 - Article

VL - 25

SP - 2192

EP - 2202

JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

IS - 7

ER -