PROFITABILITY OF THE SHARKCORE ECHOENDOSCOPY BIOPSY NEEDLE IN THE STUDY OF MEDIASTINAL PATHOLOGY

Aims Endoscopic ultrasound allows puncture sampling of thoracic structures from the esophagus. Formerly, punctures were performed with fine needles that only allowed cytological diagnosis; devices have now larger-caliber needles, obtaining cell blocks that preserve tissues architecture being possible to perform immunohistochemical techniques to optimize diagnoses. The aim of the study is to evaluate the SharkCore 22G biopsy needle (Covidien-Medtronic) to study mediastinal pathology.

Methods Retrospective, descriptive study of patients who underwent puncture of a mediastinal lesion with SharkCore 22G needle in a second-level hospital between September 2018 and May 2021. All samples were obtained using the slow-pull technique and introduced in formaldehyde.

Results 49 patients were recruited, 71% were men (median age of 65 years). Target lesion was adenopathy in 87.7% of cases, the remaining mediastinal masses. Of the 43 biopsied adenopathies, cell block was achieved in 93%, 100% in the mediastinal masses being the 100% primary lung neoplasms. Lymphadenopathy biopsies were diagnostic in 83.7% cases,diagnoses were: 41.67% benign lymphadenopathy (46.67% sarcoidosis), 33.3% metastases of pulmonary origin, 11.1% neoplastic urothelial origin and 8.33% gastrointestinal neoplasia. 42,9% of the no diagnostic biopsies were lymphomas after adenopathy resection. Median number of passes was 2, no complications were recorded.

Conclusions Puncture of mediastinal lesions with SharkCore needle has proven to be safe, allowing the collection of samples with a high rate of cell blocks and high diagnostic yield. It is especially interesting in benign pathologies, when additional techniques such as immunohistochemistry are required and characterization of lymphomas, although abundant material and experience of the pathologist is required.

Publication History

Article published online:
14 April 2022