Transcutaneous Gastrointestinal Biopsy
Gastrointestinal tract lesions, both inflammatory and/ or neoplastic, may be visualized at ultrasound as "a target" or "bull's eye" lesion, or as a "pseudokidney" mass. Although the diagnosis of nature of gastrointestinal tract lesion is conventionally based on endoscopic biopsies, since 1981 many authors have reported the possibility to reach the diagnosis of gastrointestinal neoplasia by using an ultrasound-guided biopsy. This procedure has been performed using fine needles (i.e., Needles with an outer diameter <1 mm-20 gauge) of both the "cutting" or "non cutting" type and some authors have also used large (1,2 mm-18 gauge) cutting needles. Percutaneous ultrasound-guided biopsy of a gastrointestinal mass is performed when: the lesion is well visualized at ultrasound study; the lesion is endoscopically inaccessible (i.e., Small bowel lesion); the lesion is situated in the submucosa (i.e., Lymphoma) or develops in the subserosa. (i.e., Gastrointestinal stroma tumors-GIST); a previous biopsy during endoscopy is not diagnostic or only necrotic material is obtained; endoscopy cannot be performed or it is impossible to obtain an adequate biopsy sample due to presence of severe stenosis. The analysis of the literature data shows that percutaneous ultrasound-guided biopsy of gastrointestinal mass is a highly accurate procedure (80–100 %) with a very low complications rate (< 1 %).
KeywordsGastrointestinal Stromal Tumor Fine Needle Aspiration Biopsy Gastric Lymphoma Lidocaine Hydrochloride Small Bowel Lesion
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