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Background/aims:
Endoscopic ultrasound (EUS)-guided fine-needle aspiration is very effective for providing specimens for cytological evaluation. However, the ability to provide sufficient tissue for histological evaluation has been challenging due to the technical limitations of dedicated core biopsy needles. Recently, a modified EUS needle has be...
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Citations
... Pathologic diagnosis is made mainly based on positive cell identification and histomorphometric findings, while the latter is more valuable. A complete tissue bar obtained by FNA is particularly important for some lesions requiring identification in histomorphology [17,18]. In the present study, we found that wet-heparinized suction contributed to more complete tissue bars (Fig. 4), suggesting that heparin can stabilize the structure of tissue bar to prevent breakage. ...
Background
Mediastinal lesions are diagnosed sometimes by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Wet-heparinized suction technique has been used to improve the quality of abdominal solid tumor samples obtained by EUS-FNA. The aim of the study is to assess the effect of wet-heparinized suction on the quality of mediastinal solid tumor samples and to evaluate the safety of the method.
Methods
The medical records, EUS-FNA records, pathologic data, and follow-up data between the patients who suspected mediastinal lesions with wet-heparinized suction and conventional suction were retrospectively and comparatively analyzed. Adverse events at 48 h and 1 week after EUS-FNA were evaluated.
Results
Wet-heparinized suction contributed to more tissue specimens (P < 0.05), superior tissue integrity (P < 0.05), and a longer length of white tissue core (P < 0.05). In addition, the more complete the tissue bar was, the higher the rate of successful sample (P < 0.05). Moreover, the total length of the white tissue bar at the first puncture was remarkably longer in the Experimental group (P < 0.05). No significant difference in red blood cell contamination in paraffin sections was found between the two groups (P > 0.05). There was no complication after discharge in both groups.
Conclusion
Wet-heparinized suction can improve the quality of mediastinal lesion samples obtained by EUS-FNA and increase the success rate of sampling. In addition, it will not aggravate blood contamination in paraffin sections while ensuring a safe puncture.
Background and Aims
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) primarily provides cytologic samples. EUS-guided fine-needle biopsy (EUS-FNB) with needles that provide histologic specimens may enhance diagnostic yield and facilitate accessory tissue staining. Several different needle designs are currently available and design superiority is unknown. We designed a randomized controlled trial (RCT) comparing 2 commonly used EUS-FNB needles in their ability to provide histologic tissue samples (primary endpoint) and to reach an accurate diagnosis (secondary endpoint).
Materials and Methods
A total of 150 lesions from 134 patients (November 2018-June 2019) were randomized 1:1 between biopsies with a Franseen needle and a Fork-tip needle. Both groups were compared regarding the quality of the tissue samples and diagnostic accuracy.
Results
Of 150 lesions, 75 were pancreatic and 75 were other solid lesions in and around the GI tract. There was no statistically significant difference between the Franseen needle and the Fork-tip needle in the yield of adequate histological samples, 71 out of 75 (94.7%) versus 72 out of 75 (96%), (p=1.00), an absolute difference of -1.3% (95% CI, -8.1 to 5.4%). Similarly the 2 groups were similar in the diagnostic accuracy of histological analysis, 64 out of 75 (85.3%) versus 68 out of 75 (90.7%), (p=0.45), absolute difference -5.4% (95% CI, -15.7 to 5%); and in the diagnostic accuracy of combined cytological and histological analysis, 65 out of 75 (86.7%) versus 69/75 (92%), p=0.43, absolute difference -5.3%, (95% CI, -15.2% to 4.5%).
Conclusions
There was no significant difference in the performance of Franseen versus Fork-tip needles. Both needles achieved a high yield of histological tissue samples and high diagnostic accuracy.
