Percutaneous sonographic needle aspiration biopsy of endoscopically negative gastric carcinoma

We report here the use of ultrasound-guided percutaneous fine needle aspiration gastric biopsies in three patients with endoscopically negative biopsies. Two men, ages 60 and 64, and one woman, age 64, with signs and symptoms of weight loss, abdominal pain, and early satiety, had barium contrast studies suggestive of thickened gastric walls of the antrum and cardia, yet multiple endoscopic biopsies were negative for malignancy. Using real time sector B-scan ultrasonography, percutaneous fine needle aspiration biopsy retrieved signet cell carcinomatous cytologic material in all three patients. No complications were noted. In patients with clinical and radiographic findings compatible with an infiltrative process but negative endoscopic biopsies, in whom sonography can identify a thickened stomach wall, we suggest that percutaneous fine needle aspiration biopsy be attempted.