7178 Fna and mucosectomy in submucosal gi-lesions in adjunct to eus/cus.

EUS and catheter ultrasound (CUS) have been accurate in submucosal GIlesions. Fine needle aspiration (FNA) and endoscopic mucosal resection (EMR) have been reported to enhance the ability to correctly diagnose submucosal lesions. Aim: To characterize submucosal lesions of the upper GI tract diagnosed by EUS with either FNA or EMR. Methods: Patients referred for evaluation of submucosal lesions between January 1998 and November 1999 were retrospectively reviewed. All patients were evaluated with CUS and EUS (Radial, Linear array or both). The patients were analyzed in two groups. Group I consisted of 21 patients in whom FNA was performed. Group II consisted of 7 patients in whom EMR was performed. EMR was only performed in patients with lesions confined to the mucosa or submucosa. In one patient both FNA and EMR was performed. This patient was included in both groups. Results: Overall, 29 patients were included in this study. FNA was performed in 22 patients. The mean number of passes with the FNA needle was 3, and the range was 2-8. A diagnosis was rendered in 27% (6/22) of patients in whom FNA was performed. EMR was performed in 8 patients. A diagnosis was rendered in all 8 patients in whom EMR was performed (100%). Of all submucosal lesions evaluated 10% (3/29) were potentially malignant. All potentially malignant tumors were carcinoids. In the one case where both biopsy techniques were used, both the FNA sample and the EMR sample revealed carcinoid. No complications occurred. Specific diagnosis determined at FNA or EMR are below. Conclusions: 1- FNA was diagnostic in only 27 % of patients with submucosal lesions 2. EMR was accurate in obtaining the final diagnosis in all cases. 3. EMR was safely performed in lesions up to 26mm. 4. 10% of submucosal lesions were potentially malignant