Year 2020 / Volume 112 / Number 5
Original
Endoscopic ultrasound-guided fine-needle aspiration for splenomegaly and focal splenic lesion: is it safe, effective and necessary?

355-359

DOI: 10.17235/reed.2020.6667/2019

Gabriel Mosquera-Klinger, Carlos de la Serna Higuera, Sergio Bazaga, Francisco Javier García-Alonso, Ramón Sánchez Ocaña, Beatriz Antolín Melero, Marina de Benito Sanz, Beatriz Madrigal, Ángeles Torres, Manuel Pérez-Miranda,

Abstract
Introduction: splenomegaly and/or focal splenic lesions (FSL) have limited histopathologic studies due to the risk posed by splenic punctures. Percutaneous biopsies with a fine needle are difficult, especially due to interposition of gases, ascites, obesity or a history of abdominal surgery. On the other hand, endoscopic ultrasound (EUS) takes advantage of the proximity of the gastric wall to the spleen in order to puncture and visualize the needle and its movements in real time. Objective: to describe the initial experience and results obtained with EUS-FNA in patients with splenomegaly or FSL. Materials and methods: this was a descriptive observational study. EUS-FNA of the spleen was performed with a slow-pull technique, which avoided fanning with an average of 3 needle passes. Biopsies were sent in Cytorich RedTM solution for analysis by cytology and cell block. Results: punctures were performed in 15 patients (9 females) and the median age was 67 years (range 44-86). Patients studied due to an enlarged spleen or splenic FSL, in the context of fever of an unknown origin, adenopathies and abnormal weight loss were included. A conclusive diagnosis was achieved by EUS-FNA in 10 patients (66.7 %), 4 were large cell type B non-Hodgkin's lymphoma and one Hodgkin's lymphoma. There were no immediate or delayed complications related to the procedure. Conclusions: EUS-guided splenic punctures appear to be safe, effective and may be necessary in some clinical settings in order to complete the etiologic filiation of splenomegaly of an uncertain origin or FSL and to rule out malignancy.
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Mosquera-Klinger G, de la Serna Higuera C, Bazaga S, García-Alonso F, Sánchez Ocaña R, Antolín Melero B, et all. Endoscopic ultrasound-guided fine-needle aspiration for splenomegaly and focal splenic lesion: is it safe, effective and necessary?. 6667/2019


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Publication history

Received: 06/10/2019

Accepted: 05/11/2019

Online First: 27/04/2020

Published: 08/05/2020

Article revision time: 22 days

Article Online First time: 204 days

Article editing time: 215 days


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