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. 2024 May 31;14(11):1155.
doi: 10.3390/diagnostics14111155.

Endoscopic Ultrasound-Guided Tissue Sampling for the Cytohistological Diagnosis of Focal Liver Lesions

Jose Lariño-Noia  1 , Andrea Jardi-Cuadrado  1 , Juan Enrique Dominguez-Muñoz  1 , Yessica Domínguez-Novoa  1 , Marco Galego  1 , Alberto Rama  1 , Daniel de la Iglesia-Garcia  1 , Xurxo Martinez-Seara  1 , Ihab Abdulkader-Nallib  2 , Julio Iglesias-Garcia  1
Affiliations

Endoscopic Ultrasound-Guided Tissue Sampling for the Cytohistological Diagnosis of Focal Liver Lesions

Jose Lariño-Noia et al. Diagnostics (Basel). .

Abstract

Background: Focal liver lesions (FLL) often require cytohistological evaluation. Endoscopic Ultrasound (EUS)-guided tissue acquisition (EUS-TA) is highly accurate in diagnosing pancreatic and gastrointestinal malignancies. The aim of our study was to evaluate the role of EUS-TA in the characterization of FLL.

Methods: A retrospective analysis of a prospective database of patients who underwent EUS-TA for the evaluation of FLL. Diagnostic yield, adverse events and factors associated with diagnostic yield were evaluated as endpoints. The effect of variables such as needle size, lesion size, rapid on-site evaluation (ROSE) and the use of cytological or histological needles were analyzed.

Results: A total of 114 cases were included (mean age 68.05 ± 11.35 years, 64 male). A correct diagnosis was made using EUS-TA in 100 of the 114 cases (diagnostic yield of 88%). The EUS-TA of additional extrahepatic lesions during the same EUS procedure increased the diagnostic yield to 94%. No adverse events were reported. Multivariate analysis did not identify any factor influencing the diagnostic yield.

Conclusions: EUS-TA is a highly accurate and safe technique for the differential diagnosis of FLL and could be considered as the primary approach in this setting.

Keywords: diagnostic yield; endoscopic ultrasound; focal liver lesions.

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Conflict of interest statement

José Lariño-Noia, Julio Iglesias-Garcia and Juan Enrique Dominguez-Muñoz have received honoraria as speakers from Boston Scientifc, Pentax, Abbot and Viatris. Daniel de la Iglesia-García has received honoraria as speaker from Abbot and Viatris. Andrea Jardí, Marco Galego, Alberto Rama, Xurxo Martínez, Yessica Dominguez and Ihab Abdulkader have not potential conflict of interests.

Figures

Figure 1
Figure 1
EUS-guided tissue sampling from a solid liver lesion, which corresponds to a liver metastasis from colorectal cancer.
Figure 2
Figure 2
The tissue fragments show large cells with anisonucleosis, hyperchromasia, irregular nuclear membranes, and nuclear overlap, indicating high-grade ductal adenocarcinoma (Papanicolau 40×).
Figure 3
Figure 3
Ductal adenocarcinoma. Tissue fragments of neoplastic glandular cells showing irregular nuclei and mucinous cytoplasm with desmoplastic stroma (HE 20×).
See this image and copyright information in PMC

References

    1. Elsayes K.M., Ellis J.H., Elkhouly T., Ream J.M., Bowerson M., Khan A., Caoili E.M. Diagnostic yield of percutaneous image-guided tissue biopsy of focal hepatic lesions in cancer patients: Ten percent are not metastases from primary malignancy. Cancer. 2011;117:4041–4048. doi: 10.1002/cncr.25980. - DOI - PubMed
    1. Stattaus J., Kuehl H., Ladd S., Schroeder T., Antoch G., Baba H.A., Barkhausen J., Forsting M. CT-guided biopsy of small liver lesions: Visibility, artifacts, and corresponding diagnostic accuracy. Cardiovasc. Interv. Radiol. 2007;30:928–935. doi: 10.1007/s00270-007-9023-8. - DOI - PubMed
    1. Buscarini L., Fornari F., Bolondi L., Colombo P., Livraghi T., Magnolfi F., Rapaccini G.L., Salmi A. Ultrasound-guided fine needle biopsy of focal liver lesions: Techniques, diagnostic accuracy, and complications. A retrospective study on 2091 biopsies. J. Hepatol. 1990;11:344–348. doi: 10.1016/0168-8278(90)90219-H. - DOI - PubMed
    1. Jearth V., Sundaram S., Rana S.S. Diagnostic and interventional EUS in hepatology: An updated review. Endosc. Ultrasound. 2022;11:355–370. - PMC - PubMed
    1. Laleman W., Vandershueren E., Mehdi Z.S., Wiest R., Cardenas A., Trebicka J. Endoscopic procedures in hepatology: Current trends and new developments. J. Hepatol. 2024;80:124–139. doi: 10.1016/j.jhep.2023.08.032. - DOI - PubMed

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