Role of Endoscopic Ultrasound-Guided Aspiration in the Intra-Abdominal Lesion

Abstract

Abstract Background: Endoscopic ultrasound (EUS) is a reliable, safe, rapid, cost-effective, diagnostic procedure that is, used in various intra-abdominal benign and malignant conditions. Aim: EUS-FNA cytology and histology correlation were analyzed with imaging findings and clinical details of the intra-abdominal lesions to assess the malignancy risk/specificity/sensitivity/accuracy for the individual categories. Materials and Methods: The present study was a cross-sectional study conducted in a tertiary care hospital within a period of 2½ years. A total of 107 patients with radiologically detected intra-abdominal lesion were included. The demographic data, clinical symptoms, radiologic and EUS findings, laboratory work-up, and cytology results of the study participants were collected and were compared with follow-up histopathology either from a cell block preparation or from an EUS-FNA biopsy, whichever is possible. Cytology preparations were stained routinely with Diff Quik/H&E/PAP stains, and corresponding histology sections were stained routinely with H&E stain. Immunohistochemistry analysis was also performed in difficult cases. Statistical analysis was performed by SPSS statistics software. Results: This study comprises a total of 107 cases with the age range of 7–80 years. The maximum number of cases were of the age range 51–60 years in both sexes, and the mean age was 51 years. Sixty-seven cases (63%) were males, whereas 40 cases were females, with M:F ratio = 1.7:1. Maximum cases were sampled from the pancreas, 64 (59.81%), followed by 26 (24.29%) abdominal lymph nodes. Among them, 46 (42.99%) cases were diagnosed to be benign, 41 (38.31%) cases were diagnosed to be malignant, 13 (12.14%) cases were diagnosed as suspicious/atypical, and seven cases (6.54%) were diagnosed as non-diagnostic. Statistical analysis showed 86.53% sensitivity, 84% specificity, PPV 86.53%, NPV 84.09%, and overall accuracy 76.63%. Conclusion: The EUS-FNA procedure is effective in diagnosing malignant and benign abdominal lesions and is very helpful for providing a definitive therapy at the earliest.