Endosonography-guided real-time fine-needle aspiration biopsy

M. J. Wiersema, M. L. Kochman, H. M. Cramer, L. C. Tao, L. M. Wiersema

Research output: Contribution to journalArticle

125 Scopus citations


Twenty-six patients were prospectively evaluated with endosonography- guided real-time fine-needle-aspiration biopsy. This cohort comprised 14 patients with a pancreatic mass revealed by CT or a stricture of the main pancreatic duct seen at ERCP, 7 patients with mediastinal lymphadenopathy, 3 patients with extrapancreatic abdominal masses, and 2 patients with subepithelial or infiltrative lesions. Endosonography-guided real-time fine- needle-aspiration biopsy was diagnostic in 18 of 20 patients in whom surgical confirmation was available or in whom malignancy was found and confirmed by clinical follow-up (accuracy of 90%). In the subgroup of patients with pancreatic lesions, 3 had previously undergone nondiagnostic CT-guided fine- needle-aspiration biopsy and 2 did not have evidence of a mass by CT. Real- time fine-needle-aspiration biopsy was diagnostic for malignancy in 4 of these individuals. In the 7 patients with mediastinal lymph nodes, 2 had nondiagnostic transbronchial biopsy and 2 had no evidence of mediastinal lymphadenopathy by CT scan. Endosonography-guided real-time fine-needle- aspiration biopsy diagnosed malignancy in both individuals with nondiagnostic transbronchial studies and was able to identify mediastinal lymphadenopathy in the 2 patients with negative CT scans (malignancy confirmed with real- time fine-needle-aspiration biopsy in 1). Overall, in 9 of 10 lesions in which visualization by CT was not possible (5), CT-guided fine-needle aspiration was unsuccessful (3), or prior nonsurgical biopsy techniques were unsuccessful (2), real-time fine-needle-aspiration biopsy was diagnostic. No complications were experienced in this series. Endosonography-guided real- time fine-needle-aspiration biopsy should be considered as a primary or secondary method for establishing a tissue diagnosis in patients with mediastinal and abdominal masses.

Original languageEnglish (US)
Pages (from-to)700-707
Number of pages8
JournalGastrointestinal endoscopy
Issue number6
StatePublished - 1994

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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