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Asociación Mexicana de Gastroenterología

2005, Número 3

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Rev Gastroenterol Mex 2005; 70 (3)


Biopsia por aspiración con aguja delgada guiada por ultrasonido endoscópico: primera experiencia en México

de la Mora-Levy JG, Romero-Lagarza AP, de Larios NM, López-Acosta ME, Rodríguez-Vanegas G, Farca-Belsaguy A

Idioma: Español
Referencias bibliográficas: 35
Paginas: 253-260
Archivo PDF: 73.27 Kb.


RESUMEN

Antecedentes: la biopsia por aspiración con aguja delgada (BAAD) guiada por ultrasonido endoscópico (USE) es un recurso diagnóstico reciente que ha demostrado su utilidad en múltiples situaciones clínicas. Material y métodos: estudio descriptivo y retrospectivo de la experiencia inicial con BAAD guiada por USE en el Hospital General “Dr. Manuel Gea González”, en el periodo comprendido entre marzo de 1998 y diciembre de 1999. Se utilizó ecoendoscopio lineal Pentax FG-32 UA así como dos tipos de agujas especializadas. Los procedimientos fueron realizados bajo sedación y no se contó con citopatólogo al momento de la BAAD. Se describen: sitio de biopsia, calidad de la muestra, diagnóstico citológico e histológico final, así como complicaciones. Resultados: se analizaron 40 procedimientos realizados. Las BAAD se obtuvieron de páncreas, esófago, estómago, duodeno, mediastino, recto y ganglios linfáticos. Se obtuvo un diagnóstico en 75% de los casos. En el resto, la muestra fue inadecuada o insuficiente para diagnóstico. El diagnóstico citológico se confirmó histológicamente en todos aquellos casos llevados a cirugía. Se presentaron alguna complicación en 2.5%, consistente en un caso de hemorragia autolimitada y sin repercusión clínica. Los mejores resultados se obtuvieron en ganglios linfáticos, mediastino, hígado y tumores de páncreas. Conclusiones: en este estudio se demostró la utilidad de la BAAD guiada por USE al obtener material adecuado para un diagnóstico definitivo en un porcentaje elevado de casos y con mínimas complicaciones. Se identificaron además algunos factores que permiten mejorar los resultados.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Rex DK, Tarver RD, Wiersema M, O’Conner KW, Lappas JC, Tabatowski K. Endoscopic transesophageal fine needle aspiration of mediastinal masses. Gastrointest Endosc 1991; 37: 465-8.

  2. Wiersema MJ, Hawes RH, Tao LC, Wiersema LM, Kopecky KK, Rex DK, Kumar S, Lehman GA. Endoscopic ultrasonography as an adjunct to fine needle aspiration cytology of the upper and lower gastrointestinal tract. Gastrointest Endosc 1992; 38: 35-9.

  3. Vilmann P, Hancke S, Henriksen FW, Jacobsen GK. Endosonographically-guided fine needle aspiration biopsy of malignant lesions in the upper gastrointestinal tract. Endoscopy 1993; 25: 523-7.

  4. Giovannini M, Seitz JF, Monges G, Perrier H, Rabbia L. Fine-needle aspiration cytology guided by endoscopic ultrasonography: results in 141 patients. Endoscopy 1995; 27: 171-7.

  5. Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wiersema LM. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology 1997; 112: 1087-95.

  6. DiMagno EP, Regan PT, Clain JE, James EM, Buxton JL. Human endoscopic ultrasonography. Gastroenterology 1982; 83: 824-9.

  7. Pedersen BH, Vilmann P, Folke K, Jacobsen GK, Krasnik M, Milman N, Hancke S. Endoscopic ultrasonography and real-time guided fine-needle aspiration biopsy of solid lesions of the mediastinum suspected of malignancy. Chest 1996; 110: 539-44.

  8. Hollerbach S, Willert J, Topalidis T, Reiser M, Schmiegel W. Endoscopic-ultrasound guided-fine-needle aspiration biopsy of liver lesions: histological and cytological assesment. Endoscopy 2003; 35: 743-9.

  9. Chang KJ, Albers CG, Erickson RA, Butler JA, Wuerker RB, Lin F. Endoscopic ultrasound-guided fine needle aspiration of pancreatic carcinoma. Am J Gastroenterol 1994; 89: 263-6.

  10. Lee JH, Salem R, Aslanian H, Chacho M, Topazian M. Endoscopic ultrasound and fine-needle aspiration of unexplained bile duct strictures. Am J Gastroenterol 2004; 99: 1069-73.

  11. Chang KJ, Albers CG, Nguyen P. Endoscopic ultrasound-guided fine needle aspiration of pleural and ascitic fluid. Am J Gastroenterol 1995; 90: 148-50.

  12. Chang KJ, Erickson RA, Nguyen P. Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration of the left adrenal gland. Gastrointest Endosc 1996; 44: 568-72.

  13. Fritscher-Ravens A, Mylonaki M, Pantes A, Topalidis T, Thonke F, Swain P. Endoscopic ultrasound-guided biopsy for the diagnosis of focal lesions of the spleen. Am J Gastroenterol 2003; 98(5): 1022-7.

  14. Wiersema MJ, Vazquez-Sequeiros F, Wiersema LM. Evaluation of mediastinal lymphadenopathy with endoscopic US-guided fine-needle aspiration biopsy. Radiology 2001; 219: 252-7.

  15. Bhutani MS, Hawes RH, Baron PL, Sanders-Cliette A, Van Velse A, Osborne JF, Hofmman BJ. Endoscopic ultrasound guided fine needle aspiration of malignant pancreatic lesions. Endoscopy 1997; 29: 854-8.

  16. Vander Noot MR, Eloubeidi MA, Chen VK, Eltoum I, Jhala D, Jhala N, Syed S, Chieng DC. Diagnosis of gastrointestinal tract lesions by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer 2004; 102: 157-63.

  17. Schwartz DA, Unni KK, Levy MJ, Clain JE, Wiersema MJ. The rate of false-positive results with EUS-guided fine-needle aspiration. Gastrointest Endosc 2002; 56: 868-72.

  18. Ando N, Goto H, Niwa Y, Ohmiya N, Nagasaka T, Hayakawa T. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. Gastrointest Endosc 2002; 55: 37-43.

  19. Levy MJ, Jondal ML, Clain J & Wiersema MJ. Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNA. Gastrointest Endosc 2003; 57: 101-6.

  20. Harewood GC, Wiersema LM, Halling AC, Keeney GL, Salomao DR, Wiersema MJ. Influence of EUS training and pathology interpretation on accuracy of EUS-guided fine needle aspiration of pancreatic masses. Gastrointest Endosc 2002; 55: 669-73.

  21. Bhutani MS, Suryapasad S, Moezzi J, Seabrook D. Improved technique for performing endoscopic ultrasound guided fine needle aspiration of lymph nodes. Endoscopy 1999; 31: 550-3.

  22. Wallace MB, Kennedy T, Durkalski V, Eloubeidi MA, Etamad R, Matsuda K, Lewin D, Van Velse A, Hennesey W, Hawes RH, Hoffman BJ. Randomized controlled trial of EUS-guided fine needle aspiration techniques for the detection of malignant lymphadenopathy. Gastrointest Endosc 2001; 54: 441-7.

  23. Fritscher-Ravens A, Topalidis T, Bobrowski C, Krause C, Thonke E, Jackle S, Soehendra N. Endoscopic ultrasound-guided fine-needle aspiration in focal pancreatic lesions: a prospective intraindividual comparison of two needle assemblies. Endoscopy 2001; 33: 484-90.

  24. Klapman JB, Logroño R, Dye CE, Waxman I. Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol 2003; 98: 1289-94.

  25. Erickson RA, Sayage-Rabie L, Beissner RS. Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies. Gastrointest Endosc 2000; 51: 184-90.

  26. LeBlanc JK, Ciaccia D, Al-Assi MT, McGrath K, Imperiale T, Tao LC, Vallery S, DeWitt J, Sherman S, Collins E. Optimal number of EUS-guided fine needle passes needed to obtain a correct diagnosis. Gastrointest Endosc 2004; 59: 475-81.

  27. Harewood GC, Wiersema MJ. Endosonography-guided fine needle aspiration biopsy in the evaluation of pancreatic masses. Am J Gastroenterol 2002; 97: 1386-91.

  28. Affi A, Vazquez-Sequeiros E, Norton ID, Clain JE, Wiersema MJ. Acute extraluminal hemorrhage associated with EUS-guided fine needle aspiration: frequency and clinical significance. Gastrointest Endosc 2001; 53: 221-5.

  29. O’Toole D, Palazzo L, Arotcarena R, Dancour A, Abert A, Hammel P, Amaris J, Ruszniewski P. Assessment of complications of EUS-guided fine-needle aspiration. Gastrointest Endosc 2001; 53: 470-4.

  30. Barawi M, Gottlieb K, Cunha B, Portis M, Gress F. A prospective evaluation of the incidence of bacteremia associated with EUS-guided fine-needle aspiration. Gastrointest Endosc 2001; 53: 189-92.

  31. Levy MJ, Norton ID, Wiersema MJ, Schwartz DA, Clain JE, Vazquez-Sequeiros E, Wilson WR, Zinsmeister AR, Jondal ML. Prospective risk assessment of bacteremia and other infectious complications in patients undergoing EUS-guided FNA. Gastrointest Endosc 2003; 57: 672-8.

  32. Bentz JS, Kochman ML, Faigel DO, Ginsberg G, Smith DB, Gupta PK. Endoscopic ultrasound-guided real-time fine-needle aspiration: clinicopathologic features of 60 patients. Diagn Cytopathol 1998; 18: 98-109.

  33. Williams DB, Sahai AV, Aabakken L, Penman ID, Van Velse A, Webb J, Wilson M, Hoffman BJ, Hawes RH. Endoscopic ultrasound-guided fine needle aspiration biopsy: a large single center experience. Gut 1999; 44(5): 720-6.

  34. Shin HJ, Lahoti S, Sneige N.Endoscopic ultrasound-guided fine-needle aspiration in 179 cases: the M. D. Anderson Cancer Center experience. Cancer 2002; 96(3): 174-80.

  35. Frossard JL, Amouyal P, Amouyal G, Palazzo L, Amaris J, Soldan M, Giostra E, Spahr L, Hadengue A, Fabre M. Performance of endosonography-guided fine needle aspiration biopsy in the diagnosis of pancreatic cystic lesions Am J Gastroenterol 2003; 98(7): 1516-24.




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