| Abstract: | Background: Endoscopic ultrasound‐guided fine needle aspiration biopsy (EUS‐FNAB) was developed to attain endosonographical images in real time in endoscopic biopsy, just like in percutaneous biopsy with ultrasonic or computer‐tomographical images. The results of EUS‐FNAB in esophageal and mediastinal diseases were evaluated and clinical indications of this technique were investigated. Methods: The study was performed in 58 patients, consisting of 30 with esophageal or mediastinal tumors and 28 requiring mediastinal lymph node examination. The instruments were linear array EUS transducer PEF‐703FA (Toshiba‐Fujinon, Tokyo, Japan) and 21G Endosonopsy (Hakko Shoji, Tokyo, Japan). The aspirated material was recovered on a filter paper and was formalin‐fixed to be examined histopathologically. Results: The tumors measured 6–60 mm (mean 29 mm). Collection of tissue was successful in 95% of the patients, and diagnostic accuracy was 95%. The biopsy specimen was satisfactory to establish histological diagnosis in every case of 27 patients with malignant diseases. No complication was experienced. Conclusion: The EUS‐FNAB is indicated in cases where the technique of EUS‐guided puncture is required, or is considered optimum in view of the safety and in cases where histological diagnosis is critical for the decision of treatment program. In many cases of mediastinal diseases, not even a detection of lesion is feasible without this technique, let alone a collection of tissue. The EUS‐FNAB is thus performed as a first choice of examination to obtain biopsy specimen in such cases. Endoscsopic ultrasound‐guided lymph node puncture is applied in order to assess the appropriateness of endoscopic mucosal resection (EMR) in patients with esophageal cancer, to follow up the patients after EMR and chemoradiotherapy (CRT), and to evaluate the efficacy of neoadjuvant CRT. |
