Abstract
EUS is a sensitive method for detection of intraand extra-intestinal mass lesions and peri-intestinal lymphadenopathy.1,2 EUS-guided FNA (EUS-FNA) can be performed during the diagnostic examination. EUSguided FNA is safe and has a sensitivity for detecting malignancy of 60% to over 90%, depending on site.3,4 However, several problems may arise. Determination of the adequacy of specimens at the time of the procedure by a cytopathologist or cytotechnician may not be possible in all institutions. Furthermore, the diagnosis of certain neoplasms, such as lymphoma, stromal tumors, and well-differentiated pancreatic adenocarcinoma often is difficult based on interpretation of cytologic specimens alone.3,5,6 Larger-caliber cutting needles have been developed for a variety of indications, including evaluation of both GI and non-GI tissues, and have been shown to be safe and to provide accurate results.2-12 The investigators developed a trucut biopsy needle for use with an echoendoscope (QuickCore; Wilson-Cook Medical Inc., Winston-Salem, N.C.). Our experience with EUS-guided trucut biopsy (EUSTCB) in a swine model demonstrated that histologic material representative of the target organ sampled could be acquired safely.13 A case of an esophageal leiomyoma is reported wherein EUS-TCB established the diagnosis when EUS-FNA was non-diagnostic.
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