Chang K J, Albers C G, Nguyen P
University of California, Irvine, Medical Center, Orange.
Am J Gastroenterol. 1995 Jan;90(1):148-50.
Endoscopic ultrasound (EUS) has been established as an important modality for staging gastrointestinal malignancies. We have previously described the new technique of EUS-guided fine needle aspiration (FNA) in diagnosing submucosal and extraluminal tumors and lymph nodes. We now report the novel application of EUS and EUS-guided FNA in diagnosing malignant ascites and malignant pleural effusion in two patients with gastric carcinoma. In the first patient, CT did not detect any effusion or ascites. EUS-guided FNA diagnosed cytologically that both fluids were malignant, thereby precluding surgery. The second patient had a small pleural effusion on CT that was not detected on the chest x-ray. EUS-guided FNA made the cytological diagnosis of recurrent adenocarcinoma in the pleural fluid. These two cases demonstrate for the first time that EUS combined with EUS-guided FNA can be used for the diagnosis of malignant pleural or ascitic fluid in patients with gastrointestinal malignancies and might further extend the staging capabilities of EUS.
内镜超声（EUS）已成为胃肠道恶性肿瘤分期的重要手段。我们之前曾描述过EUS引导下细针穿刺抽吸（FNA）诊断黏膜下和腔外肿瘤及淋巴结的新技术。我们现在报告EUS及EUS引导下FNA在两名胃癌患者中诊断恶性腹水和恶性胸腔积液的新应用。在首例患者中，CT未检测到任何积液或腹水。EUS引导下FNA经细胞学诊断两种液体均为恶性，从而排除了手术可能性。第二例患者CT显示有少量胸腔积液，而胸部X线未检测到。EUS引导下FNA对胸腔积液进行细胞学诊断为复发性腺癌。这两例首次证明EUS联合EUS引导下FNA可用于诊断胃肠道恶性肿瘤患者的恶性胸腔或腹水，可能进一步扩展EUS的分期能力。
