Abstract
A 76-year-old male with swelling of the ileocecal valve and lymph nodes was referred to our hospital. Although he had twice undergone endoscopic biopsy of the ileocecal valve neoplasm at another hospital, it was difficult to confirm the diagnosis. Consequently, we attempted to perform endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of one of the ileocecal lymph nodes. Generally, it is difficult to advance the scope to the ascending colon because of the oblique forward view. Thus, we devised a novel means of insertion. First, we used a sliding tube to pass through the sigmoid colon safely. Second, an over-the-wire method was performed for passing the splenic and hepatic flexures. As a result, we succeeded in advancing the scope to the ascending colon and were able to perform EUS-FNA of an ileocecal lymph node. For ileocecal lymphoma, the diagnostic rate with endoscopic biopsy is poor. Our results in this case suggest that EUS-FNA of ileocecal lymph nodes may be useful as a diagnostic method for ileocecal lymphoma.
