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Endoscopic Ultrasound-Guided Random Omental Fine Needle Aspiration: A Novel Technique for the Diagnosis of Peritoneal Carcinomatosis

Clinical Endoscopy 2020년 53권 5호 p.594 ~ 599
Siddappa Pradeep Kumar, Jain Neha, Agarwal Naveen K., Jain Monika, Lamba Gurwant Singh,
소속 상세정보
 ( Siddappa Pradeep Kumar ) - Sri Balaji Action Medical Institute Department of Gastroenterology
 ( Jain Neha ) - Sri Balaji Action Medical Institute Department of Gastroenterology
 ( Agarwal Naveen K. ) - Action Cancer Hospital Department of Pathology
 ( Jain Monika ) - Sri Balaji Action Medical Institute Department of Gastroenterology
 ( Lamba Gurwant Singh ) - Sri Balaji Action Medical Institute Department of Gastroenterology

Abstract


Background/Aims: Diagnostic abdominal paracentesis has been described in literature to have variable sensitivity of 50%?75% for the detection of peritoneal carcinomatosis (PC). We believe that random needle aspirates from the omentum, even in the absence of obvious deposits by endoscopic ultrasound (EUS), could prove malignancy in patients with PC.

Methods: Consecutive patients who underwent EUS for diagnosis and staging of cancer and found to have ascites were included after obtaining informed consent. EUS-guided fine needle aspiration (EUS-FNA) from random sites in the omentum was performed through the transgastric route using a linear echoendoscope.

Results: Fifty-four patients underwent EUS during October 2015 to April 2017 for detection, staging, or FNA of a suspected malignant lesion. Ascites was seen in 17 patients and 15 patients who fulfilled the criteria were included. The procedure was successful in all patients. Cytology was suggestive of malignancy in 12 (80%) but not suggestive of malignancy in 3 (20%) patients. Three patients who tested negative had hyperbilirubinemia with biliary obstruction. Their ascitic fluid analysis result was also negative.

Conclusions: Random FNA of the omentum in patients with malignancy-related ascites is highly effective in the diagnosis of PC and could be employed during EUS evaluation of malignancies.

키워드

Ascites; Endoscopic ultrasound; Endoscopic ultrasound-guided fine needle aspiration; Omentum; Peritoneal neoplasms

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