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Updated: Jun 23, 2026
Molecular and Immunologic Techniques in a Genetically Engineered Mouse Model of Gastrointestinal Stromal Tumor
Published on: May 2, 2022
EUS-guided sampling of suspected GI stromal tumors
Katherine M Hoda1, Sarah A Rodriguez, Douglas O Faigel
1Department of Gastroenterology/Hepatology, Oregon Health and Science University, Portland, Oregon 97239, USA.
Background:
The diagnostic yield of EUS-guided FNA (EUS-FNA) of suspected GI stromal tumors (GIST) has not been assessed in large series.
Objective:
Our purpose was to determine the diagnostic yield of EUS-FNA of subepithelial lesions with EUS features suggestive of GIST.
Design:
Retrospective database review.
Setting:
Tertiary care referral center and an urban Veterans Administration hospital.
Patients:
Consecutive patients referred for EUS evaluation of upper GI subepithelial lesions of the fourth endosonographic layer who underwent EUS-FNA.
Main Outcome Measurements:
Proportion of patients whose cytopathologic examination was diagnostic (immunohistochemical stains establish a specific diagnosis), suspicious (spindle cells identified, quantity not sufficient for specific stains), or nondiagnostic.
Results:
A total of 112 patients (45.5% female, mean age 61.6 years) underwent EUS-FNA (mean number of FNA passes 5.3). Tumor location was as follows: stomach 62.5%, esophagus 30.4%, and duodenum 7.1%. EUS-FNA was diagnostic in 61.6%, suspicious (spindle cells) in 22.3%, and nondiagnostic in 16.1%. The histologic results were 31.3% GIST, 26.8% leiomyomas, 22.3% spindle cell neoplasms, 3.5 % neural tumors, and 16.1% nondiagnostic. Fifteen (12.5%) patients also underwent EUS-guided core needle biopsy needle sampling; 7 were diagnostic, 2 suspicious, and 6 nondiagnostic. Twenty-four (20.0%) patients underwent jumbo forceps sampling; 5 were diagnostic, 1 suspicious, and 18 nondiagnostic. There were no cases of diagnostic core needle biopsy after nondiagnostic FNA core needle biopsy. Jumbo forceps biopsy of ulcerated masses was diagnostic in 3 GISTs in which FNA was nondiagnostic. Univariate and multivariate analyses showed that no variable was associated with an increased diagnostic yield.
Conclusions:
EUS-FNA sampling of subepithelial lesions was diagnostic in 61.6% and showed a spindle cell neoplasm ("suspicious") in another 22.3% (diagnostic yield 83.9%). Core needle biopsy needle sampling did not increase the yield, but in the setting of an ulcerated mass, forceps biopsy may be diagnostic.
