Cho, Chang-MinAl-Haddad, MohammadLeBlanc, Julia K.Sherman, StuartMcHenry, LeeDeWitt, John2019-04-262019-04-262013-03Cho, C.-M., Al-Haddad, M., LeBlanc, J. K., Sherman, S., McHenry, L., & DeWitt, J. (2013). Rescue Endoscopic Ultrasound (EUS)-Guided Trucut Biopsy Following Suboptimal EUS-Guided Fine Needle Aspiration for Mediastinal Lesions. Gut and Liver, 7(2), 150–156. https://doi.org/10.5009/gnl.2013.7.2.1501976-2283https://hdl.handle.net/1805/18984Background/Aims Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and Trucut biopsy (TCB) are sensitive techniques for diagnosing mediastinal lesions, but it is unclear how either one or both should be used to obtain a pathologic diagnosis. The objective of our study was to evaluate whether EUS-TCB impacts the diagnosis of mediastinal lesions after the initial on-site review of EUS-FNA specimen suggests a suboptimal result. Methods We enrolled consecutive patients with mediastinal lesions who underwent EUS-TCB during the same procedure if the initial EUS-FNA demonstrated an inadequate FNA sample or suggested that histopathology was required for diagnosis. Diagnostic accuracies between procedures were compared as the main outcome. Results Twenty-seven patients (14 men; median age, 56 years; range, 19 to 82 years) underwent EUS-FNA and EUS-TCB to evaluate a mediastinal lymphadenopathy or mass (n=17), to determine the cancer stage (n=3) or to exclude tumor recurrence or metastasis (n=7). The overall diagnostic accuracies of EUS-FNA and EUS-TCB were 78% and 67%, respectively (p=0.375). The combined diagnostic accuracy of EUS-FNA plus EUS-TCB was 82%. In six patients with nondiagnostic EUS-FNA, EUS-TCB provided a final diagnosis in one patient (17%). Conclusions In the current series of patients with mediastinal masses or adenopathy, the administration of EUS-TCB following suboptimal results for the on-site cytology review did not increase the diagnostic yield.en-USAttribution-NonCommercial 3.0 United StatesEndoscopic ultrasoundEndoscopic ultrasound-guided fine needle aspirationEndoscopic ultrasound-guided Trucut biopsyMediastinumArticle10.5009/gnl.2013.7.2.150