Lesion size determines diagnostic yield of EUS-FNA with onsite cytopathologic evaluation for upper gastrointestinal subepithelial lesions

Özet

Background/Aims: The aim of this study was to determine the diagnostic yield and factors influencing the diagnostic yield of endo-scopic ultrasound-guided fine-needle aspiration (EUS-FNA) for upper gastrointestinal (GI) subepithelial lesions (SELs) with rapid onsite cytopathologic evaluation.Materials and Methods: This is a single-center, retrospective study.Results: Among 22 patients who underwent EUS-FNA, a cytopathological diagnosis was reached in 16 (72.7%) patients. The EUS-FNA results were as follows: seven GISTs (31.8%), six leiomyomas (27.2%), four non-diagnostics (18%), two duplication cysts (9%), two spin-dle cell tumor (9%), and one ectopic pancreas (4.5%). The long-axis size was >20 mm in 12 patients (average size: 31.3 ±9.3 mm) and 20 mm was 91.6% (11/12 lesions) (Fisher’s exact test; p=0.028). Six patients underwent surgical resection. Surgical pathology results of five lesions (four GIST, one leiomyoma) were consistent with cytopathology results (83.3%). Conclusion: The diagnostic yield of EUS-FNA of the upper GI SELs with an onsite cytopathologic interpretation was 72.7%. Lesion size <2 cm significantly reduces the diagnostic yield of EUS-FNA for the upper GI SELs.