EUS-guided Trucut mural biopsies in the investigation of unexplained thickening of the esophagogastric wall

Abstract

In patients with thickened esophagogastric wall on CT but without evidence of malignancy on endoscopic mucosal biopsies, obtaining adequate histology from the gut wall is difficult. We examined whether it is feasible to obtain diagnostic tissue core from the gut wall by using EUS-guided Trucut biopsy technique in this group of patients. Ten patients were included in this study. Under EUS guidance, mucosa was penetrated by using a 19-gauge Trucut needle, and a 18-mm tissue tray was advanced obliquely through the wall layers to avoid penetration of the serosa. Then, the cutting sheath was fired over the tray. Biopsies were performed without complications. Diagnoses of carcinoma were made in 5 patients. Four other patients had benign histology, and, during follow-up, all these diagnoses have been proven to be true negatives. One Trucut biopsy specimen was considered false negative. The EUS-guided Trucut mural biopsy technique could yield diagnostic tissue cores in patients with unexplained thickening of the esophagogastric wall.