Clinical Gastroenterology Vol.28 No.13(4)

Theme Diagnostic and Interventional EUS -- Present Status and Future Perspectives
Title EUS-FNA for Pancreatobiliary and Mediastinal Lesions
Publish Date 2013/12
Author Shomei Ryozawa Digestive Disease Center, Showa University Northern Yokohama Hospital (Department of Gastroenterology, Saitama Medical University International Medical Center)
Author Hirotoshi Iwano Digestive Disease Center, Showa University Northern Yokohama Hospital (Department of Gastroenterology, Saitama Medical University International Medical Center)
Author Kumiko Taba Digestive Disease Center, Showa University Northern Yokohama Hospital (Department of Gastroenterology, Saitama Medical University International Medical Center)
Author Shogo Ohkoshi Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Haruhiro Inoue Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
[ Summary ] Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been developed over the past 20 years. By using this technique, we are able to obtain cytologic and histologic material, which is difficult to obtain without laparotomies and is important for determining therapeutic strategies for lesions. Pancreatobiliary lesions and mediastinal lesions are major indications for EUS-FNA and high diagnostic values have been reported. Rapid on-site cytopathological evaluation (ROSE) provides highly reliable diagnoses. The diagnostic yield of EUS-FNA with ROSE in most studies exceeds 90 %. However, similarly favorable results without ROSE have been reported in selected studies. These results may not apply to all situations and should be interpreted in light of specific clinical situations and resource availability. Further controlled clinical studies may be needed to clarify the technical issues related to maximizing diagnostic yields from EUS-FNA.
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