The role of endoscopic ultrasound – guided transesophageal fine needle aspiration and immunocytochem
Abstract
Ana Maria Ioncica1,2, Carmen Popescu3, Anca Malos4, Lucian Ioncica2, Monalisa Filip1, Sevastita Iordache1, Larisa Sandulescu1, Dan Ionut Gheonea1, Tudorel Ciurea1, Daniela Neagoe1, Adrian Saftoiu11 Centrul de Cercetare in Gastroenterologie si Hepatologie Craiova,
Universitatea de Medicina si Farmacie din Craiova
2 Clinica Pneumologie, Spitalul de Boli Infectioase „Victor Babes„ Craiova
3 Laboratorul de Citologie si Anatomie Patologica, Spitalul Clinic Judetean de Urgenta Craiova
4 Clinica Anestezie-Terapie Intensiva, Spitalul Clinic Judetean de Urgenta Craiova,
Universitatea de Medicina si Farmacie din Craiova, Romania
Contact: Prof. Univ. Dr. Adrian Saftoiu adry@umfcv.ro, adriansaftoiu@aim.com; Universitatea de Medicina si Farmacie Craiova, Str. Petru Rares nr. 2-4, Craiova, Dolj, 200349, Romania.www.EUSAtlas.ro
ABSTRACT
Introduction: Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) allows the assessment of the posterior mediastinum, as well as the diagnosis and staging of lung cancer patients. The purpose of this feasibility study was to assess the importance of EUS-FNA combined with cytology and immunocytochemistry for patients with suspected lung cancer and negative bronchoscopic biopsies. Material and methods: Our study included 20 consecutive patients assessed at the Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova. The patients were initially examined by chest x-ray, computer tomography scans and bronchoscopy, without a tissue confirmation of malignancy. Results and discussion: Of the 20 patients included in our study without a tissue confirmation of malignancy, 16 patients had a positive EUS-FNA for malignancy. For 11 patients the samples were obtained from the mediastinal lymphnodes, and for 4 cases directly from the primary mediastinal tumor, some of the obtained samples being included in paraffin to obtain cell blocks. The cell blocks allowed us to accomplish imunocytochemistry for two purposes: to establish the epithelial and mesenchimal fenotype of the malignant cells, as well as the origin of the identified atypical cells. Conclusions: EUS-FNA combined with cytology, is an excellent minimal invasive technique, highly accurate for the assessment of lung
cancer, showing not only the tumoral and lymph node invasion, but also offering the ideal alternative for surgical staging. Association of immunocytochemistry determined an increase in the accuracy of the method, as well as the confirmation of a tissue diagnosis of malignancy.
Key words: endoscopic ultrasound, transesophageal fine needle aspiration, pulmonary cancer
The role of endoscopic ultrasound – guided transesophageal fine needle aspiration and immunocytochemistry