engleski

Fine needle biopsy as way to get a tissue diagnosis

Introduction: During performing endoscopic ultrasound (EUS), there are several ways in which tissue samples can be taken. Usually, fine needle aspiration (FNA )is used to produce a small tissue sample sufficient for the analysis of the cytologist. Recently, fine needle biopsy (FNB) has been used, which yields larger tissue samples ideal for pathohistological diagnosis. Case report: In our institution, the EUS has been running since 2006. Following the new trends in diagnosis, we started using the FNB. So far, we have done three procedure of obtaining satisfactory tissue samples: pancreatic tumor biopsy, lung lymphoma biopsy, and lung cancer biopsy. Here is the presentation of lung biopsy in a patient whose tumor was placed apically and unavailable for taking the sample during bronchoscopy. We have decided to made EUS FNB, to avoid tumor biopsy under the control of MSCT (well being for patients and doctors) and to avoid open lung biopsy. The sample was sent to the pathologist for immunohistochemistry analysis, which set a clear diagnosis of the disease, and treatment of the patient started as soon as possible. Conclusion: EUS FNB technique requires a good understanding of human anatomy, tumor biology, the ability to control the device, and an adequate diagnostic needle. We used larger caliber cutting needles (22 gauge). That needle acquire larger tissue speciment, preserving tissue architecture and permitting histologic examination (immunohistochemistry). Needles are safe and accurate when used percutaneously, intraluminally or surgically. Diagnosing lesions arising in soft tissue, breast, lung, lymph node, pancreas, liver, kidney, adrenal, spleen, prostate. Satisfactory histologic specimens were procured in 94.7% and tissue acquisition for cytological assessment was successful in 100%, including the transduodenal route, when an expect 19 G Flex aspiration needle was used. The high tissue acquisition rate is partially because of the high elasticity of the needle, which facilitates the transduodenal pass Fine-Needle Biopsy.

fine needle biopsy ; diagnosis ; tumor

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