Abstract
Background and aimsEUS-guided FNA biopsy has been widely performed to aid in the diagnosis of submucosal tumors (SMTs). However, in cases of small tumors, the diagnostic yield of EUS-FNA is poor. Therefore, it is necessary to develop a new needle for the diagnosis. We developed a device with a new mechanism that we refer to as a drill needle aspiration biopsy (DNAB). The aim of this study was to evaluate the use of DNAB in resected gastric SMT specimens.MethodsA drill needle with a sharp tip and wide ditch was inserted into a catheter for angiography. Continuous suction is enabled through the catheter at the tip. DNAB was performed with one pass and one stroke in 13 gastric SMTs resected by operation. Similarly, FNA was performed by one pass and ten strokes. These gastric tumors included nine diagnosed gastrointestinal stromal tumors and four undiagnosed SMTs by preoperative examinations. The tissue quantity between DNAB and FNA was macroscopically and microscopically examined.ResultsAll 13 drill biopsy specimens were obtained. Additionally, all 13 gastric SMTs, including 4 undiagnosed tumors, could be diagnosed by DNAB. The quantity of each specimen obtained by DNAB was macroscopically and microscopically much greater than that by FNA. In particular, for tumors <25 mm in the longer axis, the ratio of microscopic diagnosable cases was 100 % (7/7) for DNAB and 42.9 % (3/7) for FNA.ConclusionsDNAB is a novel method that can obtain more tissue than FNA for small gastric SMT.
Highlights
Gastrointestinal stromal tumor (GIST) was first defined in 1983 as a tumor in the gastrointestinal tract and mesentery, characterized by a specific histological and immunohistochemical pattern [1]
We developed a device with a new mechanism that we refer to as a drill needle aspiration biopsy (DNAB)
DNAB was performed with one pass and one stroke in 13 gastric submucosal tumors (SMTs) resected by operation
Summary
Gastrointestinal stromal tumor (GIST) was first defined in 1983 as a tumor in the gastrointestinal tract and mesentery, characterized by a specific histological and immunohistochemical pattern [1]. Standard endoscopic biopsy specimens are typically nondiagnostic because the mucosa overlying the submucosal tumors (SMTs), including GIST, is normal. In such cases, an endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is considered to be a reliable and accurate method for the evaluation of SMTs. when the size of SMTs is small, the diagnostic yield of EUS-FNA is poor [3, 4]. EUS-guided FNA biopsy has been widely performed to aid in the diagnosis of submucosal tumors (SMTs). FNA was performed by one pass and ten strokes These gastric tumors included nine diagnosed gastrointestinal stromal tumors and four undiagnosed SMTs by preoperative examinations. For tumors \25 mm in the longer axis, the ratio of microscopic diagnosable cases was 100 % (7/7) for DNAB and 42.9 % (3/7) for FNA
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