Endoscopic ultrasound-guided fine needle aspiration biopsy for splenic tumor: a case series

Splenic tumors are occasionally found in clinical practice but the diagnosis is often difficult if only serologic and imaging tests are used. Therefore, pathologic sampling is required in such cases. Endoscopic ultrasonography (EUS) provides a good image of the spleen through the gastric wall, and a transgastric EUS-guided fine needle aspiration (EUS-FNA) biopsy may be easier than the percutaneous approach. Furthermore, a large-gauge needle may raise the capability of EUS-FNA for the histopathologic diagnosis. The aim of this study was to evaluate the yield of EUS-FNA using a large-gauge needle for a splenic tumor. Five patients with splenic tumor were subjected to EUS-FNA with a 19-gauge needle to obtain histopathologic materials. A pathologic sample was obtained in all cases, and the diagnoses were lymphoma (n = 2), sarcoidosis (n = 2), and inflammatory pseudotumor (n = 1). EUS-FNA using a 19-gauge needle is safe and useful for the diagnosis of splenic tumors.

References

• 1 Caraway N P, Fanning C V. Use of fine-needle aspiration biopsy in the evaluation of splenic lesions in a cancer center.  Diagn Cytopathol. 1997;  16 312-316
• 2 Civardi G, Vallisa D, Berte R. et al . Ultrasound-guided fine needle biopsy of the spleen: high clinical efficacy and low risk in a multicenter Italian study.  Am J Hematol. 2001;  67 93-99
• 3 Kraus M D, Fleming M D, Vonderheide R H. The spleen as a diagnostic specimen: a review of 10 years’ experience at two tertiary care institutions.  Cancer. 2001;  91 2001-2009
• 4 Kumar P V, Monabati A, Raseki A R. et al . Splenic lesions: FNA findings in 48 cases.  Cytopathology. 2007;  18 151-156
• 5 Friedlander M A, Wei X J, Iyengar P. et al . Diagnostic pitfalls in fine needle aspiration biopsy of the spleen.  Diagn Cytopathol. 2008;  36 69-75
• 6 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
• 7 Iwashita T, Yasuda I, Doi S. et al . The yield of endoscopic ultrasound-guided fine needle aspiration for histological diagnosis in patients suspected of stage I sarcoidosis.  Endoscopy. 2008;  40 400-405
• 8 Fritscher-Ravens A, Mylonaki M, Pantes A. et al . Endoscopic ultrasound-guided biopsy for the diagnosis of focal lesions of the spleen.  Am J Gastroenterol. 2003;  98 1022-1027
• 9 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
• 10 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