Endoscopic ultrasonography (EUS) is a well-established method of evaluating patients with gastrointestinal and pulmonary malignancies. EUS allows accurate tumor staging through the detection of local and distant lymph-node metastases, particularly in the area of the celiac axis [1]
[2]
[3]. Since the original reports of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) by Vilmann et al. [4] and Wiersema et al. [5], EUS-FNA of peri-intestinal lesions has become adopted as a routine method allowing cytological documentation of malignant involvement. This article outlines the principles used in evaluating the celiac axis with EUS and the methods of carrying out EUS-FNA of celiac lymph nodes, and it suggests absolute indications, relative indications, and contraindications to EUS-FNA of the celiac lymph nodes.
References
1
Eloubeidi M A, Chen V K, Volk A L. et al .
Recurrent metastatic Klatskin’s carcinoid tumor to celiac lymph nodes in a teenager: diagnosis by endoscopic ultrasound-guided fine needle aspiration biopsy with immunocytochemical correlation.
Dig Dis Sci.
2003;
48
2301-2305
2
Eloubeidi M A, Wallace M B, Reed C E. et al .
The utility of EUS and EUS-guided fine needle aspiration in detecting celiac lymph node metastasis in patients with esophageal cancer: a single-center experience.
Gastrointest Endosc.
2001;
54
714-719
3
Vazquez-Sequeiros E, Wiersema M J, Clain J E. et al .
Impact of lymph node staging on therapy of esophageal carcinoma.
Gastroenterology.
2003;
125
1626-1635
4
Vilmann P, Jacobsen G K, Henriksen F W. et al .
Endoscopic ultrasonography with guided fine needle aspiration biopsy in pancreatic disease.
Gastrointest Endosc.
1992;
38
172-173
5
Wiersema M J, Kochman M L, Chak A. et al .
Real-time endoscopic ultrasound-guided fine-needle aspiration of a mediastinal lymph node.
Gastrointest Endosc.
1993;
39
429-431
6
Eloubeidi M A, Wallace M B, Hoffman B J. et al .
Predictors of survival for esophageal cancer patients with and without celiac axis lymphadenopathy: impact of staging endosonography.
Ann Thorac Surg.
2001;
72
212-219
9
Hiele M, de Leyn P, Schurmans P. et al .
Relation between endoscopic ultrasound findings and outcome of patients with tumors of the esophagus or esophagogastric junction.
Gastrointest Endosc.
1997;
45
381-386
10
Siemsen M, Svendsen L B, Knigge U.
A prospective randomized comparison of curved array and radial echoendoscopy in patients with esophageal cancer.
Gastrointest Endosc.
2003;
58
671-676
11
Levy M J, Jondal M L, Clain J. et al .
Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNA.
Gastrointest Endosc.
2003;
57
101-106
12
Klapman J B, Logrono R, Dye C E. et al .
Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration.
Am J Gastroenterol.
2003;
98
1289-1294
13
Ribeiro A, Vazquez-Sequeiros E, Wiersema L M. et al .
EUS-guided fine-needle aspiration combined with flow cytometry and immunocytochemistry in the diagnosis of lymphoma.
Gastrointest Endosc.
2001;
53
485-491
15
Wallace M B, Kennedy T, Durkalski V. et al .
Randomized controlled trial of EUS-guided fine needle aspiration techniques for the detection of malignant lymphadenopathy.
Gastrointest Endosc.
2001;
54
441-447
16
van Dam J, Rice T W, Catalano M F. et al .
High-grade malignant stricture is predictive of esophageal tumor stage: risks of endosonographic evaluation.
Cancer.
1993;
71
2910-2917
17
Pfau P R, Ginsberg G G, Lew R J. et al .
Esophageal dilation for endosonographic evaluation of malignant esophageal strictures is safe and effective.
Am J Gastroenterol.
2000;
95
2813-2815
18
Wallace M B, Hawes R H, Sahai A V. et al .
Dilation of malignant esophageal stenosis to allow EUS guided fine-needle aspiration: safety and effect on patient management.
Gastrointest Endosc.
2000;
51
309-313
19
Binmoeller K F, Seifert H, Seitz U. et al .
Ultrasonic esophagoprobe for TNM staging of highly stenosing esophageal carcinoma.
Gastrointest Endosc.
1995;
41
547-552
20
Mallery S, van Dam J.
Increased rate of complete EUS staging of patients with esophageal cancer using the nonoptical, wire-guided echoendoscope.
Gastrointest Endosc.
1999;
50
53-57
21
Affi A, Vazquez-Sequeiros E, Norton I D. et al .
Acute extraluminal hemorrhage associated with EUS-guided fine needle aspiration: frequency and clinical significance.
Gastrointest Endosc.
2001;
53
221-225
22
Giovannini M, Seitz J F, Monges G. et al .
Fine-needle aspiration cytology guided by endoscopic ultrasonography: results in 141 patients.
Endoscopy.
1995;
27
171-177
23
Reed C E, Mishra G, Sahai A V. et al .
Esophageal cancer staging: improved accuracy by endoscopic ultrasound of celiac lymph nodes.
Ann Thorac Surg.
1999;
67
319-321
24
Williams D B, Sahai A V, Aabakken L. et al .
Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience.
Gut.
1999;
44
720-726
