EUS-guided fine needle aspiration of the liver: indications, yield, and safety based on an international survey of 167 cases.
BACKGROUND: The liver is a common site of metastases for various malignancies. EUS-guided fine needle aspiration (EUS-FNA) of liver masses has only been reported in small series from single centers. METHODS: A retrospective questionnaire was sent by e-mail to 130 EUS-FNA centers around the world regarding indications, complications, and findings of EUS-FNA of the liver. RESULTS: Twenty-one centers reported 167 cases of EUS-FNA of the liver. A complication was reported in 6 (4%) of 167 cases including the following: death in 1 patient with an occluding biliary stent and biliary sepsis, bleeding (1), fever (2), and pain (2). EUS-FNA diagnosed malignancy in 23 of 26 (89%) cases after nondiagnostic fine needle aspiration under transabdominal US guidance. EUS localized an unrecognized primary tumor in 17 of 33 (52%) cases in which CT had demonstrated only liver metastases. EUS image characteristics were not predictive of malignant versus benign lesions. CONCLUSION: EUS-guided FNA of the liver appears to be a safe procedure with a major complication rate of approximately 1%. EUS-FNA should be considered when a liver lesion is poorly accessible to US-, or CT-guided FNA should be considered when US- or CT-guided FNA fail to make a diagnosis, when a liver lesion(s) is detected (de novo) by EUS, and for investigation of possible upper GI primary tumors in the setting of liver metastases.
tenBerge, J; Hoffman, BJ; Hawes, RH; Van Enckevort, C; Giovannini, M; Erickson, RA; Catalano, MF; Fogel, R; Mallery, S; Faigel, DO; Ferrari, AP; Waxman, I; Palazzo, L; Ben-Menachem, T; Jowell, PS; McGrath, KM; Kowalski, TE; Nguyen, CC; Wassef, WY; Yamao, K; Chak, A; Greenwald, BD; Woodward, TA; Vilmann, P; Sabbagh, L; Wallace, MB
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