Interventionelle Methoden in der Endokrinologie: Untersuchungen zur endosonographisch gesteuerten transluminalen Feinnadelpunktion, endoskopischen farbkodierten Duplexsonographie und transiliakalen Knochenbiopsie

Silke Meyer, Innere Medizin, Kann, Peter Herbert (Prof. Dr.)
Interventional methods are rarely used in endocrinology. In order to investigate quality, relevance, complication rate and tolerability of these methods, endosonographically-guided transluminal fine-needle aspiration biopsies of the adrenals and other paraintestinal organs (a), endoscopic color-coded duplex sonography of adrenal lesions (b) and transiliacal bone biopsies of unclear metabolic bone diseases were retrospectively examined. (a) Endoscopic ultrasound (EUS) enables the visualization
more » ... the visualization of paraintestinal organs with the option of the diagnostic technique of the endosonographically-guided transluminal fine-needle aspiration biopsy (EUS-FNA). The aim was to evaluate specimen quality and complication rate of EUS-FNA of the adrenals and other paraintestinal organs. EUS-FNA was performed using a PENTAX FG 32 UA endosonoscope in combination with a needle system type Hancke-Vilmann. 72 EUS-FNA specimens of 44 EUS-FNAs in 41 patients (pancreas: n=13; adrenals: n=9; abdominal lesions: n= 6; mediastinum: n=13) were evaluated about their specimen quality and contamination with tissue from the needle pathway. 16 vs. 11 of 34 histopathologic and 38 cytologic specimens were classified excellent, 7 vs. 10 sufficient, 7 vs. 13 poor and 4 vs. 4 failed. Analysis of contamination with tissue from the needle pathway showed 4 vs. 2 specimens highly, 3 vs. 14 clearly, 8 vs. 19 slightly and 19 vs. 3 not contaminated. Specimens classified excellent were less contaminated (p=0,037). EUS-FNA identified 35 benign and 24 malignant masses. Definite diagnosis failed in 13 specimens. One non-fatal complication (asymptomatic bleeding) occurred. Specimen classification was possible in 64 of 72 specimens (89%). Poor specimen quality was accompanied by contamination with tissue from the needle pathway. EUS-FNA expands the possibility of diagnosing difficult positioned masses especially in endocrinologic cases. (b) Tumor classification of adrenal masses by endosonomorphological critera is difficult. Here, the aim was to evaluate the perfus [...]
doi:10.17192/z2006.0181 fatcat:u2os7roljvbq3dmr7ahg5peyg4