The addition of a large caliber needle during endoscopic ultrasound-guided fine needle aspiration of solid and lymph...

The benefits of using multiple gauge needles during EUS-FNA of solid and lymph node lesions are unknown. The purpose of our study was to find out the significance of adding a large caliber needle if small caliber needle fail to achieve diagnostic specimen after few passes.

It was a retrospective review of all EUS-FNA procedures performed by one of the two experienced endosonographers. A large (22 or 19 gauge) needle was added if on-site cytologic analysis did not reveal adequate specimen after ≥2 passes. The adequacy of the specimen was determined by the Cytopathologist, and categorized as either satisfactory for analysis or unsatisfactory. The cytologic findings were reported as either benign or malignant.

Out of total 1200 EUS cases, FNA was performed in 306 cases with different solid and lymph node lesions. Multiple gauge needles were used in 188/306 (39%) cases. There was no statistically significant difference in the diagnostic yield and definitive diagnosis between multiple and single gauge needle groups. The finding was unchanged after controlling the number of needle passes. No complications were noted.

The addition of a large caliber needle achieved at least the same (or even slightly higher diagnostic yield), and can be a method of rescue in certain cases.