PDF icon PDF herunterladen
Z Gastroenterol 2008; 46(9): 897-908
DOI: 10.1055/s-2008-1027419
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Endosonografisch gestützte Biopsie: diagnostischer Ertrag, Fallstricke, Qualitätssicherung

Teil 2: Differenzialdiagnostische Möglichkeiten, Fallstricke und ProblemlösungenEndoscopic ultrasound-guided biopsy: diagnostic yield, pitfalls, quality managementPart 2: Opportunities of differential diagnosis, pitfalls, and problem solutionsC. Jenssen1 , K. Möller2 , S. Wagner3 , M. Sarbia4
  • 1Klinik für Innere Medizin, Krankenhaus Märkisch Oderland GmbH
  • 2Medizinische Klinik I – Gastroenterologie/Akutgeriatrie, Sana Klinikum Lichtenberg
  • 3Gemeinschaftspraxis für Pathologie, Königs Wusterhausen
  • 4Gemeinschaftspraxis Pathologie und Zytologie, München
Weitere Informationen

Publikationsverlauf

Manuskript eingetroffen: 11.2.2008

Manuskript akzeptiert: 2.4.2008

Publikationsdatum:
22. September 2008 (online)

Auch verfügbar aufeRef
   Lizenzen und Reprints
Preview

Zusammenfassung

Zahlreiche tumoröse Veränderungen beispielsweise von Pankreas, Leber, Nebenniere und gastrointestinaler Wandung sowie vergrößerte Lymphknoten sind differenzialdiagnostisch vieldeutig. Eine spezifische feingewebliche Diagnose ist Voraussetzung für differenzierte Therapieentscheidungen. Die endosonografische Biopsie ist entweder primär oder nach Versagen anderer Biopsietechniken ein sehr sicherer und effektiver Weg zur Materialgewinnung für zytologische und histologische Untersuchungen. Die Reproduzierbarkeit der zytopathologischen Diagnosen an endosonografisch gewonnenen Aspiraten ist für mit den Besonderheiten des Materials erfahrenen Zytopathologen sehr hoch. Falsch positive Malignitätsdiagnosen nach endosonografischer Feinnadelpunktion sind Raritäten, falsch negative kommen dagegen abhängig vom Zielgewebe, technischen Faktoren sowie der Erfahrung von Endosonografieteam und Zytopathologen in variabler Häufigkeit vor. Die differenzialdiagnostische Einordnung maligner und benigner Befunde ist im Regelfall möglich, allerdings bestehen zahlreiche Probleme und Fallstricke. Diese ergeben sich einerseits aus den Besonderheiten des bei der endosonografisch gestützten Biopsie gewonnenen Materials, andererseits aus der Vielfalt von möglichen Artdiagnosen, deren zytologische und histologische Merkmale sich teilweise überlappen oder stark ähneln können. In der vorliegenden Übersicht werden die artdiagnostischen Möglichkeiten an endosonografisch-feinnadelbioptisch gewonnenem Material, mögliche Fallstricke sowie Wege zur Minimierung der differenzialdiagnostischen Irrtumswahrscheinlichkeit diskutiert.

Abstract

The differential diagnosis of tumorous lesions in the pancreas, liver, adrenal gland or lymph nodes is ambiguous. Specific tissue diagnoses are essential for treatment decisions. Endoscopic ultrasound-guided biopsy has proven to be a reliable and effective modality in obtaining samples for cytological or histological examinations either primarily or in cases in which other biopsy techniques have failed. The reproducibility of cytopathological diagnoses among pathologists with special experience in assessing material obtained by endoscopic ultrasound-guided biopsies is very high. False positive diagnoses of malignancy in endoscopic ultrasound-guided biopsy are rare; false negative diagnoses appear in a variable frequency depending on target tissue, technical factors, and expertise of the endosonographer and cytopathologist. There are numerous challenges and pitfalls in the differential diagnostic classification of benign and malignant lesions. These problems are related to the characteristics of samples obtained by endoscopic ultrasound-guided biopsy, as well as to the multiple diagnoses with similar or overlapping cytological or histological characteristics. This review discusses the performance of endoscopic ultrasound-guided biopsy in establishing specific tissue diagnoses, possible pitfalls as well as opportunities to minimise differential diagnostic errors.

Schlüsselwörter

Endosonografie (EUS) - endosonografisch gestützte Feinnadelaspirationsbiopsie (EUS-FNA) - endosonografisch gestützte Trucut-Biopsie (EUS-TCB) - Qualität - Fallstricke - diagnostischer Irrtum

Key words

endoscopic ultrasound (EUS) - endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA) - endoscopic ultrasound-guided trucut biopsy (EUS-TCB) - quality - pitfalls - diagnostic errors

Literatur

  • 1 Jenssen C, Möller M, Sarbia M. et al .Endosonographische Biopsie (EUS-FNA, EUS-TCB) – Fallstricke, Probleme und Problemlösungen. Dietrich CF Endosonographie. Lehrbuch und Atlas des endoskopischen Ultraschalls Stuttgart, New York; Thieme 2008: 87-140
    Suche in Google Scholar
  • 2 Skov B G, Baandrup U, Jakobsen G K. et al . Cytopathologic diagnoses of fine-needle aspirations from endoscopic ultrasound of the mediastinum: reproducibility of the diagnoses and representativeness of aspirates from lymph nodes.  Cancer. 2007;  111 234-241
    Suche in Google Scholar
  • 3 Annema J T, Versteegh M I, Veselic M. et al . Endoscopic ultrasound added to mediastinoscopy for preoperative staging of patients with lung cancer.  JAMA. 2005;  294 931-936
    Suche in Google Scholar
  • 4 Gerhard R, da Cunha S G. Inter- and intraobserver reproducibility of thyroid fine needle aspiration cytology: an analysis of discrepant cases.  Cytopathology. 2007;  18 105-111
    Suche in Google Scholar
  • 5 Adamsen S, Olsen M, Jendresen M B. et al . Endobiliary brush biopsy: Intra- and interobserver variation in cytological evaluation of brushings from bile duct strictures.  Scand J Gastroenterol. 2006;  41 597-603
    Suche in Google Scholar
  • 6 Melia J, Moseley R, Ball R Y. et al . A UK-based investigation of inter- and intra-observer reproducibility of Gleason grading of prostatic biopsies.  Histopathology. 2006;  48 644-654
    Suche in Google Scholar
  • 7 Srivastava A, Odze R D, Lauwers G Y. et al . Morphologic features are useful in distinguishing Barrett esophagus from carditis with intestinal metaplasia.  Am J Surg Pathol. 2007;  31 1733-1741
    Suche in Google Scholar
  • 8 Jenssen C, Möller K, Wagner S. et al . Endosonographisch gestüzte Biopsie: diagnostischer Ertrag, Fallstricke, Qualitätssicherung. Teil 1: Optimierung von Materialgewinnung und diagnostischer Effizienz.  Z Gastroenterol. 2008;  46 590-600
    Suche in Google Scholar
  • 9 Eloubeidi M A, Tamhane A, Jhala N. et al . Agreement between rapid onsite and final cytologic interpretations of EUS-guided FNA specimens: implications for the endosonographer and patient management.  Am J Gastroenterol. 2006;  101 2841-2847
    Suche in Google Scholar
  • 10 Jhala N C, Eltoum I A, Eloubeidi M A. et al . Providing on-site diagnosis of malignancy on endoscopic-ultrasound-guided fine-needle aspirates: should it be done?.  Ann Diagn Pathol. 2007;  11 176-181
    Suche in Google Scholar
  • 11 Ardengh J C, Paulo G A, Ferrari A P. EUS-guided FNA in the diagnosis of pancreatic neuroendocrine tumors before surgery.  Gastrointest Endosc. 2004;  60 378-384
    Suche in Google Scholar
  • 12 Eloubeidi M A, Varadarajulu de S, Desai S. et al . A prospective evaluation of an algorithm incorporating routine preoperative endoscopic ultrasound-guided fine needle aspiration in suspected pancreatic cancer.  J Gastrointest Surg. 2007;  11 813-819
    Suche in Google Scholar
  • 13 Jhala N C, Jhala D N, Chhieng D C. et al . Endoscopic ultrasound-guided fine-needle aspiration. A cytopathologist’s perspective.  Am J Clin Pathol. 2003;  120 351-367
    Suche in Google Scholar
  • 14 Stelow E B, Bardales R H, Stanley M W. Pitfalls in endoscopic ultrasound-guided fine-needle aspiration and how to avoid them.  Adv Anat Pathol. 2005;  12 62-73
    Suche in Google Scholar
  • 15 Ardengh J C, Lopes C V, Campos A D. et al . Endoscopic ultrasound and fine needle aspiration in chronic pancreatitis: differential diagnosis between pseudotumoral masses and pancreatic cancer.  JOP. 2007;  8 413-421
    Suche in Google Scholar
  • 16 Fritscher-Ravens A, Brand L, Knofel W T. et al . Comparison of endoscopic ultrasound-guided fine needle aspiration for focal pancreatic lesions in patients with normal parenchyma and chronic pancreatitis.  Am J Gastroenterol. 2002;  97 2768-2775
    Suche in Google Scholar
  • 17 Jenssen C, Dietrich C F. Endosonographie bei chronischer Pankreatitis.  Z Gastroenterol. 2005;  43 737-749
    Suche in Google Scholar
  • 18 Stelow E B, Bardales R H, Lai R. et al . The cytological spectrum of chronic pancreatitis.  Diagn Cytopathol. 2005;  32 65-69
    Suche in Google Scholar
  • 19 Varadarajulu S, Tamhane A, Eloubeidi M A. Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis.  Gastrointest Endosc. 2005;  62 728-736
    Suche in Google Scholar
  • 20 Möller K. Sonovue als Wegweiser für die endosonographisch gestützte Punktion eines Pankreaskopftumors (abstract).  Ultraschall in Med. 2004;  25 DOI: 10.1055 /s-2004-834 213
    Suche in Google Scholar
  • 21 Hocke M, Schulze E, Gottschalk P. et al . Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer.  World J Gastroenterol. 2006;  12 246-250
    Suche in Google Scholar
  • 22 Hocke M, Ignee A, Topalidis T. et al . Contrast-enhanced endosonographic Doppler spectrum analysis is helpful in discrimination between focal chronic pancreatitis and pancreatic cancer.  Pancreas. 2007;  35 286-288
    Suche in Google Scholar
  • 23 Jhala N, Jhala D, Vickers S M. et al . Biomarkers in Diagnosis of pancreatic carcinoma in fine-needle aspirates.  Am J Clin Pathol. 2006;  126 572-579
    Suche in Google Scholar
  • 24 Nagle J A, Wilbur D C, Pitman M B. Cytomorphology of gastric and duodenal epithelium and reactivity to B 72.3: a baseline for comparison to pancreatic lesions aspirated by EUS-FNAB.  Diagn Cytopathol. 2005;  33 381-386
    Suche in Google Scholar
  • 25 Salek C, Benesova L, Zavoral M. et al . Evaluation of clinical relevance of examining K-ras, p16 and p53 mutations along with allelic losses at 9 p and 18q in EUS-guided fine needle aspiration samples of patients with chronic pancreatitis and pancreatic cancer.  World J Gastroenterol. 2007;  13 3714-3720
    Suche in Google Scholar
  • 26 Wang Y, Gao J, Li Z. et al . Diagnostic value of mucins (MUC1, MUC2 and MUC5AC) expression profile in endoscopic ultrasound-guided fine-needle aspiration specimens of the pancreas.  Int J Cancer. 2007;  121 2716-2722
    Suche in Google Scholar
  • 27 Chen Y, Zheng B, Robbins D H. et al . Accurate discrimination of pancreatic ductal adenocarcinoma and chronic pancreatitis using multimarker expression data and samples obtained by minimally invasive fine needle aspiration.  Int J Cancer. 2007;  120 1511-1517
    Suche in Google Scholar
  • 28 Maluf-Filho F, Kumar A, Gerhardt R. et al . Kras mutation analysis of fine needle aspirate under EUS guidance facilitates risk stratification of patients with pancreatic mass.  J Clin Gastroenterol. 2007;  41 906-910
    Suche in Google Scholar
  • 29 Itoi T, Takei K, Sofuni A. et al . Immunohistochemical analysis of p53 and MIB-1 in tissue specimens obtained from endoscopic ultrasonography-guided fine needle aspiration biopsy for the diagnosis of solid pancreatic masses.  Oncol Rep. 2005;  13 229-234
    Suche in Google Scholar
  • 30 Khalid A, Nodit L, Zahid M. et al . Endoscopic ultrasound fine needle aspirate DNA analysis to differentiate malignant and benign pancreatic masses.  Am J Gastroenterol. 2006;  101 2493-2500
    Suche in Google Scholar
  • 31 Laurell H, Bouisson M, Berthelemy P. et al . Identification of biomarkers of human pancreatic adenocarcinomas by expression profiling and validation with gene expression analysis in endoscopic ultrasound-guided fine needle aspiration samples.  World J Gastroenterol. 2006;  12 3344-3351
    Suche in Google Scholar
  • 32 Mishra G, Zhao Y, Sweeney J. et al . Determination of qualitative telomerase activity as an adjunct to the diagnosis of pancreatic adenocarcinoma by EUS-guided fine-needle aspiration.  Gastrointest Endosc. 2006;  63 648-654
    Suche in Google Scholar
  • 33 Schoedel K E, Finkelstein S D, Ohori N P. K-Ras and microsatellite marker analysis of fine-needle aspirates from intraductal papillary mucinous neoplasms of the pancreas.  Diagn Cytopathol. 2006;  34 605-608
    Suche in Google Scholar
  • 34 Takahashi K, Yamao K, Okubo K. et al . Differential diagnosis of pancreatic cancer and focal pancreatitis by using EUS-guided FNA.  Gastrointest Endosc. 2005;  61 76-79
    Suche in Google Scholar
  • 35 Ashida R, Nakata B, Inoue H. et al . Chemoresistance-related genes profile in specimens obtained by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) (abstract).  Gastrointest Endosc. 2006;  63 AB93
    Suche in Google Scholar
  • 36 Itoi T, Sofuni A, Itokawa F. et al . Effect of ribonucleotide reductase subunit 2 mRNA expression in pretreatment biopsies obtained from pancreatic carcinomas (abstract).  Gastrointest Endosc. 2006;  63 AB252
    Suche in Google Scholar
  • 37 Steg A, Vickers S M, Eloubeidi M. et al . Hedgehog pathway expression in heterogeneous pancreatic adenocarcinoma: implications for the molecular analysis of clinically available biopsies.  Diagn Mol Pathol. 2007;  16 229-237
    Suche in Google Scholar
  • 38 Deshpande V, Mino-Kenudson M, Brugge W R. et al . Endoscopic ultrasound guided fine needle aspiration biopsy of autoimmune pancreatitis: diagnostic criteria and pitfalls.  Am J Surg Pathol. 2005;  29 1464-1471
    Suche in Google Scholar
  • 39 Levy M J, Reddy R P, Wiersema M J. et al . EUS-guided trucut biopsy in establishing autoimmune pancreatitis as the cause of obstructive jaundice.  Gastrointest Endosc. 2005;  61 467-472
    Suche in Google Scholar
  • 40 Dietrich C F, Barreiros A P, Jenssen C. Zystische, neuroendokrine und andere seltene Pankreastumoren. Dietrich CF Endosonographie. Lehrbuch und Atlas des endoskopischen Ultraschalls Stuttgart, New York; Thieme 2008: 287-331
    Suche in Google Scholar
  • 41 Stelow E B, Shami V M, Abbott T E. et al . The use of fine needle aspiration cytology for the distinction of pancreatic mucinous neoplasia.  Am J Clin Pathol. 2008;  129 67-74
    Suche in Google Scholar
  • 42 Frossard J L, Amouyal P, Amouyal G. et al . Performance of endosonography-guided fine needle aspiration and biopsy in the diagnosis of pancreatic cystic lesions.  Am J Gastroenterol. 2003;  98 1516-1524
    Suche in Google Scholar
  • 43 Huang P, Staerkel G, Sneige N. et al . Fine-needle aspiration of pancreatic serous cystadenoma: cytologic features and diagnostic pitfalls.  Cancer. 2006;  108 239-249
    Suche in Google Scholar
  • 44 Attasaranya S, Pais S, LeBlanc J. et al . Endoscopic ultrasound-guided fine needle aspiration and cyst fluid analysis for pancreatic cysts.  JOP. 2007;  8 553-563
    Suche in Google Scholar
  • 45 Emerson R E, Randolph M L, Cramer H M. Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of intraductal papillary mucinous neoplasm of the pancreas is highly predictive of pancreatic neoplasia.  Diagn Cytopathol. 2006;  34 457-462
    Suche in Google Scholar
  • 46 Stelow E B, Stanley M W, Bardales R H. et al . Intraductal papillary-mucinous neoplasm of the pancreas. The findings and limitations of cytologic samples obtained by endoscopic ultrasound-guided fine-needle aspiration.  Am J Clin Pathol. 2003;  120 398-404
    Suche in Google Scholar
  • 47 Khalid A, McGrath K M, Zahid M. et al . The role of pancreatic cyst fluid molecular analysis in predicting cyst pathology.  Clin Gastroenterol Hepatol. 2005;  3 967-973
    Suche in Google Scholar
  • 48 Jenssen C, Dietrich C F. Endosonographie bei chronischer Pankreatitis – Diagnostik, Differenzialdiagnostik, Therapie. Dietrich CF Endosonographie. Lehrbuch und Atlas des endoskopischen Ultraschalls Stuttgart, New York; Thieme 2008: 232-269
    Suche in Google Scholar
  • 49 Dewitt J, Jowell P, LeBlanc J. et al . EUS-guided FNA of pancreatic metastases: a multicenter experience.  Gastrointest Endosc. 2005;  61 689-696
    Suche in Google Scholar
  • 50 Fritscher-Ravens A, Izbicki J R, Sriram P V. et al . Endosonography-guided, fine-needle aspiration cytology extending the indication for organ-preserving pancreatic surgery.  Am J Gastroenterol. 2000;  95 2255-2260
    Suche in Google Scholar
  • 51 Fritscher-Ravens A, Sriram P V, Krause C. et al . Detection of pancreatic metastases by EUS-guided fine-needle aspiration.  Gastrointest Endosc. 2001;  53 65-70
    Suche in Google Scholar
  • 52 Mesa H, Stelow E B, Stanley M W. et al . Diagnosis of nonprimary pancreatic neoplasms by endoscopic ultrasound-guided fine-needle aspiration.  Diagn Cytopathol. 2004;  31 313-318
    Suche in Google Scholar
  • 53 Chang F, Chandra A, Culora G. et al . Cytologic diagnosis of pancreatic endocrine tumors by endoscopic ultrasound-guided fine-needle aspiration: a review.  Diagn Cytopathol. 2006;  34 649-658
    Suche in Google Scholar
  • 54 Chang F, Vu C, Chandra A. et al . Endoscopic ultrasound-guided fine needle aspiration cytology of pancreatic neuroendocrine tumours: cytomorphological and immunocytochemical evaluation.  Cytopathology. 2006;  17 10-17
    Suche in Google Scholar
  • 55 Jani N, Dewitt J, Eloubeidi M. et al . Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas: a multicenter experience.  Endoscopy. 2008;  40 200-203
    Suche in Google Scholar
  • 56 Bardales R H, Centeno B, Mallery J S. et al . Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid-pseudopapillary tumor of the pancreas: a rare neoplasm of elusive origin but characteristic cytomorphologic features.  Am J Clin Pathol. 2004;  121 654-662
    Suche in Google Scholar
  • 57 Jhala D, Eloubeidi M, Chhieng D C. et al . Fine needle aspiration biopsy of the islet cell tumor of pancreas: a comparison between computerized axial tomography and endoscopic ultrasound-guided fine needle aspiration biopsy.  Ann Diagn Pathol. 2002;  6 106-112
    Suche in Google Scholar
  • 58 Lin H, Li S D, Hu X G. et al . Primary pancreatic lymphoma: report of six cases.  World J Gastroenterol. 2006;  12 5064-5067
    Suche in Google Scholar
  • 59 Master S S, Savides T J. Diagnosis of solid-pseudopapillary neoplasm of the pancreas by EUS-guided FNA.  Gastrointest Endosc. 2003;  57 965-968
    Suche in Google Scholar
  • 60 Mergener K, Detweiler S E, Traverso L W. Solid pseudopapillary tumor of the pancreas: diagnosis by EUS-guided fine-needle aspiration.  Endoscopy. 2003;  35 1083-1084
    Suche in Google Scholar
  • 61 Stelow E B, Bardales R H, Shami V M. et al . Cytology of pancreatic acinar cell carcinoma.  Diagn Cytopathol. 2006;  34 367-372
    Suche in Google Scholar
  • 62 Dodd L G, Evans D B, Symmans F. et al . Fine-needle aspiration of pancreatic extramedullary plasmacytoma: possible confusion with islet cell tumor.  Diagn Cytopathol. 1994;  10 371-374
    Suche in Google Scholar
  • 63 Eloubeidi M A, Jhala D, Chhieng D C. et al . Multiple late asymptomatic pancreatic metastases from renal cell carcinoma: diagnosis by endoscopic ultrasound-guided fine needle aspiration biopsy with immunocytochemical correlation.  Dig Dis Sci. 2002;  47 1839-1842
    Suche in Google Scholar
  • 64 Baron T H. Endoscopic US for metastases to the pancreas: chasing the satellites.  Gastrointest Endosc. 2005;  61 697-699
    Suche in Google Scholar
  • 65 Nodit L, McGrath K M, Zahid M. et al . Endoscopic ultrasound-guided fine needle aspirate microsatellite loss analysis and pancreatic endocrine tumor outcome.  Clin Gastroenterol Hepatol. 2006;  4 1474-1478
    Suche in Google Scholar
  • 66 Jenssen C, Dietrich C F. Endosonographie bei subepithelialen Tumoren des Verdauungstraktes. Dietrich CF Endosonographie. Lehrbuch und Atlas des endoskopischen Ultraschalls Stuttgart, New York; Thieme 2008: 190-225
    Suche in Google Scholar
  • 67 Jenssen C, Dietrich C F. Endoscopic ultrasound of subepithelial lesions, review.  Ultraschall in Med. 2008 (akzeptiert zur Publikation); 
    Suche in Google Scholar
  • 68 Fu K, Eloubeidi M A, Jhala N C. et al . Diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration biopsy – a potential pitfall.  Ann Diagn Pathol. 2002;  6 294-301
    Suche in Google Scholar
  • 69 Ando N, Goto H, Niwa Y. et al . The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis.  Gastrointest Endosc. 2002;  55 37-43
    Suche in Google Scholar
  • 70 Gomes A L, Bardales R H, Milanezi F. et al . Molecular analysis of c-Kit and PDGFRA in GISTs diagnosed by EUS.  Am J Clin Pathol. 2007;  127 89-96
    Suche in Google Scholar
  • 71 Kinoshita K, Isozaki K, Tsutsui S. et al . Endoscopic ultrasonography-guided fine needle aspiration biopsy in follow-up patients with gastrointestinal stromal tumours.  Eur J Gastroenterol Hepatol. 2003;  15 1189-1193
    Suche in Google Scholar
  • 72 Okubo K, Yamao K, Nakamura T. et al . Endoscopic ultrasound-guided fine-needle aspiration biopsy for the diagnosis of gastrointestinal stromal tumors in the stomach.  J Gastroenterol. 2004;  39 747-753
    Suche in Google Scholar
  • 73 Stelow E B, Stanley M W, Mallery S. et al . Endoscopic ultrasound-guided fine-needle aspiration findings of gastrointestinal leiomyomas and gastrointestinal stromal tumors.  Am J Clin Pathol. 2003;  119 703-708
    Suche in Google Scholar
  • 74 Akahoshi K, Sumida Y, Matsui N. et al . Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration.  World J Gastroenterol. 2007;  13 2077-2082
    Suche in Google Scholar
  • 75 Jenssen C, Schick B, Wagner S. Erstdiagnose eines serös-papillären Ovarialkarzinoms durch endosonographische Feinnadelaspirationsbiopsie eines submukösen Magentumors: ein Fallbericht.  Endo heute. 2006;  19 32-35
    Suche in Google Scholar
  • 76 Aithal G P, Anagnostopoulos G K, Kaye P. EUS-guided Trucut mural biopsies in the investigation of unexplained thickening of the esophagogastric wall.  Gastrointest Endosc. 2005;  62 624-629
    Suche in Google Scholar
  • 77 Polkowsky M, Gerke W, Nasierowska-Guttmejer A. et al . EUS-guided trucut biopsy of hypoechoic intramural tumors of the stomach: a single-center experience in 17 cases (abstract).  Endoscopy. 2006;  39 DOI: 10.1055/s-2006-947771
    Suche in Google Scholar
  • 78 Ribeiro A, Vernon S, Quintela P. EUS-guided trucut biopsy with immunohistochemical analysis of a gastric stromal tumor.  Gastrointest Endosc. 2004;  60 645-648
    Suche in Google Scholar
  • 79 Saftoiu A, Vilmann P, Guldhammer S B. et al . Endoscopic ultrasound (EUS)-guided Trucut biopsy adds significant information to EUS-guided fine-needle aspiration in selected patients: a prospective study.  Scand J Gastroenterol. 2007;  42 117-125
    Suche in Google Scholar
  • 80 Storch I, Jorda M, Thurer R. et al . Advantage of EUS Trucut biopsy combined with fine-needle aspiration without immediate on-site cytopathologic examination.  Gastrointest Endosc. 2006;  64 505-511
    Suche in Google Scholar
  • 81 Yadav D, Levy M J, Schwartz D. et al . EUS-guided trucut biopsy for diagnosis of an esophageal stromal tumor: case report.  Gastrointest Endosc. 2003;  58 457-460
    Suche in Google Scholar
  • 82 Meara R S, Cangiarella J, Simsir A. et al . Prediction of aggressiveness of gastrointestinal stromal tumours based on immunostaining with bcl-2, Ki-67 and p53.  Cytopathology. 2007;  18 283-289
    Suche in Google Scholar
  • 83 Gu M, Ghafari S, Nguyen P T. et al . Cytologic diagnosis of gastrointestinal stromal tumors of the stomach by endoscopic ultrasound-guided fine-needle aspiration biopsy: cytomorphologic and immunohistochemical study of 12 cases.  Diagn Cytopathol. 2001;  25 343-350
    Suche in Google Scholar
  • 84 Stelow E B, Murad F M, Debol S M. et al . A limited immunocytochemical panel for the distinction of subepithelial gastrointestinal mesenchymal neoplasms sampled by endoscopic ultrasound-guided fine-needle aspiration.  Am J Clin Pathol. 2008;  129 219-225
    Suche in Google Scholar
  • 85 Agarwal B, Gogia S, Eloubeidi M A. et al . Malignant mediastinal lymphadenopathy detected by staging EUS in patients with pancreaticobiliary cancer.  Gastrointest Endosc. 2005;  61 849-853
    Suche in Google Scholar
  • 86 Gleeson F C, Rajan E, Levy M J. et al . EUS-guided FNA of regional lymph nodes in patients with unresectable hilar cholangiocarcinoma.  Gastrointest Endosc. 2008;  67 438-443
    Suche in Google Scholar
  • 87 Hahn M, Faigel D O. Frequency of mediastinal lymph node metastases in patients undergoing EUS evaluation of pancreaticobiliary masses.  Gastrointest Endosc. 2001;  54 331-335
    Suche in Google Scholar
  • 88 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
    Suche in Google Scholar
  • 89 Wallace M B, Block M, Hoffman B J. et al . Detection of telomerase expression in mediastinal lymph nodes of patients with lung cancer.  Am J Respir Crit Care Med. 2003;  167 1670-1675
    Suche in Google Scholar
  • 90 Wallace M B, Block M I, Gillanders W. et al . Accurate molecular detection of non-small cell lung cancer metastases in mediastinal lymph nodes sampled by endoscopic ultrasound-guided needle aspiration.  Chest. 2005;  127 430-437
    Suche in Google Scholar
  • 91 Al Haddad M, Wallace M B. EUS-FNA and biomarkers for the staging of non-small cell lung cancer.  Endoscopy. 2006;  38 Suppl 1 S114-S117
    Suche in Google Scholar
  • 92 Annema J T, Veselic M, Rabe K F. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of sarcoidosis.  Eur Respir J. 2005;  25 405-409
    Suche in Google Scholar
  • 93 Michael H, Ho S, Pollack B. et al . Diagnosis of intra-abdominal and mediastinal sarcoidosis with EUS-guided FNA.  Gastrointest Endosc. 2008;  67 28-34
    Suche in Google Scholar
  • 94 Fritscher-Ravens A, Sriram P V, Topalidis T. et al . Diagnosing sarcoidosis using endosonography-guided fine-needle aspiration.  Chest. 2000;  118 928-935
    Suche in Google Scholar
  • 95 Fritscher-Ravens A, Sriram P V, Topalidis T. et al . Endoscopic ultrasonography-guided fine-needle cytodiagnosis of mediastinal metastases from renal cell cancer.  Endoscopy. 2000;  32 531-535
    Suche in Google Scholar
  • 96 Fritscher-Ravens A, Sriram P V, Bobrowski C. et al . Mediastinal lymphadenopathy in patients with or without previous malignancy: EUS-FNA-based differential cytodiagnosis in 153 patients.  Am J Gastroenterol. 2000;  95 2278-2284
    Suche in Google Scholar
  • 97 Krishna N B, Gardner L, Collins B T. et al . Periportal lymphadenopathy in patients without identifiable pancreatobiliary or hepatic malignancy.  Clin Gastroenterol Hepatol. 2006;  4 1373-1377
    Suche in Google Scholar
  • 98 Mishra G, Sahai A V, Penman I D. et al . Endoscopic ultrasonography with fine-needle aspiration: an accurate and simple diagnostic modality for sarcoidosis.  Endoscopy. 1999;  31 377-382
    Suche in Google Scholar
  • 99 Pugh J L, Jhala N C, Eloubeidi M A. et al . Diagnosis of deep-seated lymphoma and leukemia by endoscopic ultrasound-guided fine-needle aspiration biopsy.  Am J Clin Pathol. 2006;  125 703-709
    Suche in Google Scholar
  • 100 Südhoff T, Hollerbach S, Wilhelms I. et al . Klinische Wertigkeit der endosonographischen Feinnadelpunktion bei Erkrankungen des oberen Gastrointestinaltrakts und Mediastinums.  Dtsch Med Wochenschr. 2004;  129 2227-2232
    Suche in Google Scholar
  • 101 Stelow E B, Lai R, Bardales R H. et al . Endoscopic ultrasound-guided fine-needle aspiration of lymph nodes: the Hennepin County Medical Center experience.  Diagn Cytopathol. 2004;  30 301-306
    Suche in Google Scholar
  • 102 Yasuda I, Tsurumi H, Omar S. et al . Endoscopic ultrasound-guided fine-needle aspiration biopsy for lymphadenopathy of unknown origin.  Endoscopy. 2006;  38 919-924
    Suche in Google Scholar
  • 103 Wildi S M, Judson M A, Fraig M. et al . Is endosonography guided fine needle aspiration (EUS-FNA) for sarcoidosis as good as we think?.  Thorax. 2004;  59 794-799
    Suche in Google Scholar
  • 104 Mehra M, Tamhane A, Eloubeidi M A. EUS-guided FNA combined with flow cytometry in the diagnoses of suspected or recurrent intrathoracic or retroperitoneal lymphoma.  Gastrointest Endosc. 2005;  62 508-513
    Suche in Google Scholar
  • 105 Eloubeidi M A, Varadarajulu S, Eltoum I. et al . Transgastric endoscopic ultrasound-guided fine-needle aspiration biopsy and flow cytometry of suspected lymphoma of the spleen.  Endoscopy. 2006;  38 617-620
    Suche in Google Scholar
  • 106 Chang K J, Erickson R A, Nguyen P. Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration of the left adrenal gland.  Gastrointest Endosc. 1996;  44 568-572
    Suche in Google Scholar
  • 107 Dewitt J, Alsatie M, LeBlanc J. et al . Endoscopic ultrasound-guided fine-needle aspiration of left adrenal gland masses.  Endoscopy. 2007;  39 65-71
    Suche in Google Scholar
  • 108 Eloubeidi M A, Seewald S, Tamhane A. et al . EUS-guided FNA of the left adrenal gland in patients with thoracic or GI malignancies.  Gastrointest Endosc. 2004;  59 627-633
    Suche in Google Scholar
  • 109 Jhala N C, Jhala D, Eloubeidi M A. et al . Endoscopic ultrasound-guided fine-needle aspiration biopsy of the adrenal glands: analysis of 24 patients.  Cancer. 2004;  102 308-314
    Suche in Google Scholar
  • 110 Kramer H, Sanders J, Post W J. et al . Analysis of cytological specimens from mediastinal lesions obtained by endoscopic ultrasound-guided fine-needle aspiration.  Cancer. 2006;  108 206-211
    Suche in Google Scholar
  • 111 Stelow E B, Debol S M, Stanley M W. et al . Sampling of the adrenal glands by endoscopic ultrasound-guided fine-needle aspiration.  Diagn Cytopathol. 2005;  33 26-30
    Suche in Google Scholar
  • 112 DeWitt J M. Endoscopic ultrasound-guided fine-needle aspiration of right adrenal masses: report of 2 cases.  J Ultrasound Med. 2008;  27 261-267
    Suche in Google Scholar
  • 113 Eloubeidi M A, Morgan D E, Cerfolio R J. et al . Transduodenal EUS-guided FNA of the right adrenal gland.  Gastrointest Endosc. 2008;  67 522-527
    Suche in Google Scholar
  • 114 Nürnberg D. Sonographie von Nebennierentumoren – wann ist die Punktion indiziert?.  Ultraschall in Med. 2005;  26 458-469
    Suche in Google Scholar
  • 115 Akdamar M K, Eltoum I, Eloubeidi M A. Retroperitoneal paraganglioma: EUS appearance and risk associated with EUS-guided FNA.  Gastrointest Endosc. 2004;  60 1018-1021
    Suche in Google Scholar
  • 116 Jenssen C, Siebert C, Bartho S. Leiomyosarkom der Vena cava inferior – Diagnose durch endosonographisch gestützte Feindelaspirationsbiopsie.  Dtsch Med Wochenschr. 2008;  133 769-772
    Suche in Google Scholar
  • 117 Catalano M F, Sial S, Chak A. et al . EUS-guided fine needle aspiration of idiopathic abdominal masses.  Gastrointest Endosc. 2002;  55 854-858
    Suche in Google Scholar
  • 118 Anand D, Barroeta J E, Gupta P K. et al . Endoscopic ultrasound guided fine needle aspiration of non-pancreatic lesions: an institutional experience.  J Clin Pathol. 2007;  60 1254-1260
    Suche in Google Scholar
  • 119 Erickson R A, Tretjak Z. Clinical utility of endoscopic ultrasound and endscopic ultrasound-guided fine needle aspiration in retroperitoneal neoplasms.  Am J Gastroenterol. 2000;  95 1188-1194
    Suche in Google Scholar
  • 120 Hollerbach S, Reiser M, Topalidis T. et al . Diagnosis of hepatocellular carcinoma (HCC) in a high-risk patient by using transgastric EUS-guided fine-needle biopsy (EUS-FNA).  Z Gastroenterol. 2003;  41 995-998
    Suche in Google Scholar
  • 121 Nguyen P, Feng J C, Chang K J. Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (FNA) of liver lesions.  Gastrointest Endosc. 1999;  50 357-361
    Suche in Google Scholar
  • 122 Singh P, Erickson R A, Mukhopadhyay P. et al . EUS for detection of the hepatocellular carcinoma: results of a prospective study.  Gastrointest Endosc. 2007;  66 265-273
    Suche in Google Scholar
  • 123 Crowe D R, Eloubeidi M A, Chhieng D C. et al . Fine-needle aspiration biopsy of hepatic lesions: computerized tomographic-guided versus endoscopic ultrasound-guided FNA.  Cancer. 2006;  108 180-185
    Suche in Google Scholar
  • 124 Logrono R, Waxman I. Interactive role of the cytopathologist in EUS-guided fine needle aspiration: an efficient approach.  Gastrointest Endosc. 2001;  54 485-490
    Suche in Google Scholar
  • 125 Kulesza P, Eltoum I A. Endoscopic ultrasound-guided fine-needle aspiration: sampling, pitfalls, and quality management.  Clin Gastroenterol Hepatol. 2007;  5 1248-1254
    Suche in Google Scholar

Dr. Christian Jenssen

Klinik für Innere Medizin, Krankenhaus Märkisch Oderland GmbH

Prötzeler Chaussee 5

15344 Strausberg

Telefon: ++ 49/33 41/5 28 22

eMail: c.jenssen@khmol.de