ENDOSCOPIC ULTRASOUND GUIDED FINE NEEDLE ASPIRATION CYTOLOGY FOR THE DIAGNOSIS OF DIGESTIVE DISEASES (2ND REPORT) IN SPECIAL REFERENCE TO THE DIAGNOSIS AND TREATMENT OF SUBMUCOSAL TUMORS OF THE UPPER GASTROINTESTINAL TRACT

Abstract

Endoscopic ultrasonography (EUS) is an indispensable means for the diagnosis of submucosal tumors of the upper gastrointestinal tract. However, in remains difficult to defferentiate between malignant and benign lesions. Therefore, the EUS-guided fine needle aspiration (FNA) cytology is a ratinal method for the diagnosis of submucosal tumors of the upper G. I. tract. EUS guided FNA cytology using the Olympus Prototype XGF-UC4 was performed in 14 patients with submucosal tumor of the upper gastrointestinal tract (7 were operated upon and the other 7 were not). The obtained rate of specimens by FNA was 86%, and the adoption of the new puncture system greatly contributed to the improvement of the rate. The diagnostic value of EUS guided FNA cytology for malignancies in our series was as follows. Sensitivity was 83%, Specificity 100%, the ture positive value 100%, the ture negative value 83% and the overall accuracy rate 91%. No complications were encountered. Taking into account previously reported pathological analyses, the treatment of choice whether operation or follow-up for myogenic tumors should be selected by tumor size, internal echo and FNA cytology. In conclusion, EUS guided FNA cytology has the potential of becoming a very advantageous approach for therapeutic purpose as well as diagnostic purpose in submucosal tumors.