Background and Study Aims: Endoscopic ultrasonography (EUS) has recently been reported to be useful in the diagnosis of submucosal tumors, but there are some cases in which the EUS diagnosis is questionable. We evaluated the diagnostic usefulness of endoscopic ultrasonography-guided fine needle aspiration biopsy (EUS-FNAB) in such cases. Patients and Methods: From October 1993 to May 1997, EUS-FNAB was performed in 22 patients with upper gastrointestinal submucosal tumors who had also undergone EUS. We analyzed the capability of EUS-FNAB diagnosis compared to that of EUS imaging alone (presumptive diagnosis). Results: Adequate specimens for histological diagnosis by EUS-FNAB were obtained in 18 of the 22 patients (82%). In 15 cases the final diagnosis was based on surgery. EUS-FNAB was correct in 14 of 15 lesions. In contrast, EUS alone suggested a correct diagnosis in only nine lesions. Conclusions: EUS-FNAB may be able to establish a histologic diagnosis, and whenever histology is deemed necessary EUS-FNAB would be an option. EUS-FNAB may increase the diagnostic capability of EUS in differentiating between submucosal tumors.
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