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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Can EUS-guided FNA distinguish between gallbladder cancer and xanthogranulomatous cholecystitis?
Gastrointestinal Endoscopy, Volume 72, No. 3, Year 2010
Notification
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Description
Background: EUS-guided FNA (EUS-FNA) is a useful modality for sampling various targets, but its applicability to gallbladder (GB) mass lesions is limited. Objective: To determine the usefulness of EUS-FNA for diagnosing GB mass lesions. Design: Single-center, retrospective, case-series study. Setting: Tertiary-care referral center. Patients: This study involved 15 consecutive patients who underwent EUS-FNA of GB mass lesions. We punctured GB masses in patients with suspected xanthogranulomatous cholecystitis to distinguish them from malignancy, and in patients with unresectable GB carcinoma for pathological confirmation. The final diagnosis was based on surgical histopathological results or follow-up outcome. Interventions: EUS-FNA. Main Outcome Measurements: Evaluation of EUS-FNA sampling adequacy rate and diagnostic yield. Results: Xanthogranulomatous cholecystitis was suspected in 6 of the 15 patients. EUS-FNA revealed foam cells (n = 3), inflammatory cells (n = 1, proven by cholecystectomy), and GB carcinoma (n = 1), and the amount of the aspirate was insufficient in one case (xanthogranulomatous cholecystitis was later proven by extended hepatectomy). The mean follow-up period of the patients with xanthogranulomatous cholecystitis was 1177 days. Adenocarcinoma was confirmed by EUS-FNA in 8 of the 9 patients with suspected unresectable GB carcinoma, and the FNA was inconclusive in one. All 10 patients with GB carcinoma underwent chemotherapy. The overall sampling adequacy was 86.6%. The accuracy of EUS-FNA for detecting malignancy and for the final diagnosis was 93.3% (95% CI, 62.4%-99.9%) and 80% (95% CI, 54%-93.7%), respectively. Limitations: A small patient cohort and a retrospective design with potential selection bias. Conclusions: Malignant GB mass lesions can be safely and accurately differentiated by EUS-FNA. Thus, patients with xanthogranulomatous cholecystitis can avoid undue extensive surgery. © 2010 American Society for Gastrointestinal Endoscopy.
Authors & Co-Authors
Hijioka, Susumu
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Mekky, M. A.
Egypt, Asyut
Faculty of Medicine
Bhatia, Vikram K.
India, New Delhi
Institute of Liver and Biliary Sciences
Sawaki, Akira
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Mizuno, Nobumasa
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Hara, Kazuo
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Hosoda, Waki
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Shimizu, Yashuhiro
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Tamada, Kiichi
Japan, Kawachi District
Jichi Medical University
Niwa, Yasumasa
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Yamao, Kenji
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Statistics
Citations: 70
Authors: 11
Affiliations: 4
Identifiers
Doi:
10.1016/j.gie.2010.05.022
ISSN:
00165107
e-ISSN:
10976779
Research Areas
Cancer
Health System And Policy
Study Design
Cohort Study