Differential diagnosis of tumors in upper GI muscularis propria by EUS guided fine needle aspiration and immunohistochemical evaluation / 中华消化内镜杂志

ABSTRACT

Objective It is difficult to differentiate tumors in upper GI muscularis proporia, such as GI stromal tumors (GISTs) , leiomyomas and schwannomas. We performed EUS guided fine needle aspirations (FNA) and immunohistochemical evaluation of these tumors in upper GI muscularis proporia. Methods We selected 35 Patients with lesions in upper GI muscularis proporia by EGD and EUS. We assessed the shape , size, and position of the lesions and the status of metastasis. After excluding blood vessel between the lesions and the fine needle, EUS FNA were carried out and immunohistochemical staining for CD-117 (c-kit) , CD34 and smooth muscle actin ( SMA) was performed. Results All patients were performed EUS FNA and enough specimens were obtained in 31 patients. The other 4 failed, although we tried it for several times. Among the 31 patients, Cytology and immunohistochemisty demonstrated 21 GISTs and 10 leiomyomas. All the results were evaluated by surgery. The sensitivity is 88. 6% , and the speciality is 100%. No complication occurred. Conclusion EUS-guided FNA and immunohistochemical evaluation is an accurate method for diferential diagnosis of tumors in upper GI muscularis propria.