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EUS-FNA of the Esophagus and Mediastinum

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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].

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References

  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]

    PubMed  Google Scholar 

  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):98–103

    CAS  PubMed Central  PubMed  Google Scholar 

  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.2008.06.021

    Google Scholar 

  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]

    PubMed  Google Scholar 

  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-2002-34262

    CAS  PubMed  Google Scholar 

  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]

    CAS  PubMed  Google Scholar 

  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]

    PubMed  Google Scholar 

  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.x

    CAS  PubMed  Google Scholar 

  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.2004.06.089

    PubMed  Google Scholar 

  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):215–220

    CAS  PubMed  Google Scholar 

  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): 698–705

    CAS  PubMed  Google Scholar 

  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.2001.112841

    CAS  PubMed  Google Scholar 

  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]

    PubMed  Google Scholar 

  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.2010.01.059

    PubMed  Google Scholar 

  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-0029-1244133

    CAS  PubMed  Google Scholar 

  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:AB216

    Google Scholar 

  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]

    CAS  PubMed Central  PubMed  Google Scholar 

  18. Fritscher-Ravens A, Sriram PV, Topalidis T et al (2000) Diagnosing sarcoidosis using endosonography-guided fine-needle aspiration. Chest 118(4):928–935

    CAS  PubMed  Google Scholar 

  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] 10.1183/09031936.05.00098404

    CAS  PubMed  Google Scholar 

  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 85–94

    Google Scholar 

  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]

    PubMed  Google Scholar 

  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]

    PubMed  Google Scholar 

  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]

    CAS  PubMed  Google Scholar 

  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]

    CAS  PubMed  Google Scholar 

  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]

    CAS  PubMed  Google Scholar 

  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-2004-826042

    CAS  PubMed  Google Scholar 

  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.20369

    PubMed  Google Scholar 

  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.0000045024.16388.96

    PubMed  Google Scholar 

  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]

    PubMed  Google Scholar 

  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–166S

    PubMed  Google Scholar 

  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] 10.1159/000081765

    PubMed  Google Scholar 

  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]

    CAS  PubMed  Google Scholar 

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Correspondence to Amol Bapaye M.D. (M.S.) .

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Bapaye, A., Aher, A. (2012). EUS-FNA of the Esophagus and Mediastinum. In: Akahoshi, K., Bapaye, A. (eds) Practical Handbook of Endoscopic Ultrasonography. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54014-4_15

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  • DOI: https://doi.org/10.1007/978-4-431-54014-4_15

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54013-7

  • Online ISBN: 978-4-431-54014-4

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