Endoscopic Ultrasound in the Diagnosis of Sarcoidosis: A Forgotten Tool?
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SUBMITTER: P B S
PROVIDER: S-EPMC7605182 | biostudies-literature | 2020 Nov
REPOSITORIES: biostudies-literature
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Endoscopic Ultrasound in the Diagnosis of Sarcoidosis: A Forgotten Tool?
P B Sryma S Mittal Saurabh S Madan Karan K Mohan Anant A Tiwari Pawan P Hadda Vijay V
American journal of respiratory and critical care medicine 20201101 9
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| S-EPMC11241469 | biostudies-literature
Project description:Hepatocellular carcinoma (HCC) is an aggressive tumor and a leading cause of cancer-related deaths globally. The mortality rate remains high despite many advances in treatment. HCC is frequently diagnosed late in its course due to lack of classical symptoms at earlier stages. Endoscopic ultrasound (EUS) has emerged as an important diagnostic tool for the diagnostic evaluation, staging, and treatment of gastrointestinal tract disorders. EUS-guided fine needle aspiration has been a valuable addition to EUS by being able to obtain tissue under direct visualization. Here, we review the potential role of EUS in the diagnosis and management of HCC. EUS seems to be a safe and reliable alternative method for obtaining tissue for diagnosis of liver cancer, especially for lesions that are inaccessible by traditional methods. EUS could play an important role in the diagnosis and management of HCC.
| S-EPMC4918294 | biostudies-literature
Project description:IntroductionGastrointestinal tuberculosis (TB), specifically gastric TB, is a rare form of extrapulmonary TB. Diagnosis proves challenging with nonspecific signs and symptoms. In this case report, a 22-year-old male came in with complaints of recurrent hematemesis and melena.Case presentationWe found a submucosal mass with ulceration in the stomach cardia on esophagoduodenoscopy (EGD). The endoscopic ultrasound (EUS) finding was a hypoechoic submucosal lesion with a clear margin; specimens were taken using fine needle aspiration (FNA) for further histopathological examination. The result indicated granuloma of Mycobacterium Tuberculosis in pathology, suggesting that the diagnosis was gastric TB. The patient was then treated with antitubercular therapy regimen for 9 months. The previously documented mass in the stomach cardia was no longer visible on the follow-up endoscopy examination, and the patient was considered cured.ConclusionThis case shows that gastric tuberculosis should be considered in patients with gastrointestinal symptoms, especially those living in TB endemic regions. Endoscopic examinations, such as EGD and EUS, may aid in the diagnosis of gastric tuberculosis.
| S-EPMC11324280 | biostudies-literature
Project description:Background and study aims Although small hypervascular tumors are suspected to be pancreatic neuroendocrine tumors (p-NENs), their diagnosis and treatment are challenging. This study evaluated the usefulness of endoscopic ultrasound-guided tissue acquisition (EUS-TA) for diagnosis of small p-NENs. Methods All p-NEN lesions that underwent EUS-TA at our hospital between April 2018 and December 2023 were retrospectively analyzed. The diagnostic sensitivity of EUS-TA and the concordance rate of grading with EUS-TA and surgical specimens were examined. The lesions were grouped by size. Results The diagnostic sensitivity of EUS-TA was analyzed for 82 lesions, of which 44 were compared with postoperative specimens for grading. The definitive diagnosis was neuroendocrine tumor (NET) in 75 lesions, neuroendocrine carcinoma in five lesions, and mixed neuroendocrine non-neuroendocrine neoplasm in two lesions. Thirty tumors were ≤10 mm, 30 were 10 to 20 mm, and 22 were >20 mm, and the diagnostic sensitivities were 96.7%, 96.7%, and 90.9%, respectively. Concordance rates for grading were 94.4%, 82.4%, and 77.8% for tumors ≤10 mm, 10 to 20 mm, and ≥20 mm, respectively, with Cohen's kappa coefficients of 0.64, 0.48, and 0.40, respectively. Conclusions EUS-TA showed adequate diagnostic sensitivity and grading agreement for p-NENs of all sizes, allowing for determination of appropriate treatment.
| S-EPMC11604306 | biostudies-literature
Project description:ObjectivesAmong subepithelial lesions (SELs), gastrointestinal stromal tumors (GISTs) should be identified and surgically treated at an early stage. However, it is difficult to diagnose SELs smaller than 20 mm. In recent years, endoscopic ultrasound (EUS) elastography (EUS-EG) and contrast-enhanced harmonic EUS (CH-EUS) have been reported to be useful for the diagnosis of SELs, although the diagnostic accuracy of a combination of EUS techniques with image enhancement is unknown.MethodsPatients with SELs who underwent EUS-guided tissue acquisition, EUS shear-wave elastography (EUS-SWE), EUS strain elastography (EUS-SE), and CH-EUS from January 2019 to June 2023 were enrolled. To assess the diagnostic accuracy for differentiating GISTs from other SELs, shear-wave velocity on EUS-SWE, the strain ratio on EUS-SE, and vascularity on CH-EUS were determined and their diagnostic accuracies were compared.ResultsForty-three patients were enrolled. When the cut-off value was set at 3.27 m/s, the sensitivity, specificity, and diagnostic accuracy of shear-wave velocity were 28.6%, 86.2%, and 34.9%, respectively. When the cut-off value was set at 3.79, the sensitivity, specificity, and diagnostic accuracy of the strain ratio were 93.1%, 64.3%, and 83.7%, respectively. The sensitivity, specificity, and diagnostic accuracy of CH-EUS were 79.3%, 92.3%, and 83.7%, respectively. When EUS-SE was combined with CH-EUS, the sensitivity and diagnostic accuracy were the highest among binary combinations of image enhancement modalities.ConclusionsEUS-SE and CH-EUS are useful for differentiating GISTs from other SELs. Furthermore, the use of both modalities may further improve the identification of GISTs.
| S-EPMC11470742 | biostudies-literature
Project description:Background and study aims To assess the diagnostic value of contrast-enhanced endoscopic ultrasound (CE-EUS) for autoimmune pancreatitis and other solid pancreatic masses. Patients and methods A systematic search of PubMed, Embase, and Web of Science was performed from inception to October 2022. We calculated individual and pooled sensitivities and specificities to determine the diagnostic ability of CE-EUS. In addition, we calculated I 2 to test for heterogeneity and explored the source of heterogeneity by meta-regression analysis. Results A total of 472 patients from seven eligible studies were included. The mean sensitivity and specificity of the Bivariate analysis were 0.84 (95% CI 0.71-0.92) and 0.95 (95% CI 0.84-0.99), respectively. The diagnostic advantage ratio was 107.91 (95% confidence interval [CI] 22.22-524.13), and the area under the summary receiver operating characteristics curve was 0.91 (95% CI 0.88-0.93). The overall heterogeneity of the studies is negligible (I 2 =0, 95% CI 0-100). However, notable heterogeneity was observed in the combined specificity ( P <0.01, I 2 =74.82) and diagnostic odds ratio ( P =0.05, I 2 =51.54). The heterogeneity in these aspects could be elucidated through sensitivity analysis. Conclusions Our analysis showed that CE-EUS is useful in identifying autoimmune pancreatitis. However, further large sample size, multicenter, prospective studies are needed to demonstrate its utility.
| S-EPMC11466521 | biostudies-literature
Project description:BackgroundEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an effective technique used to precisely detect enlarged mediastinal lymph nodes. The efficacy of EBUS-TBNA versus standard modalities for the diagnosis of sarcoidosis remains to be elucidated. In this meta-analysis, we compared the efficacies of these methods.MethodsWe searched PubMed, Embase, The Cochrane Library, Wanfang, Cpvip, CNKI, and the bibliographies of the relevant references. We analyzed the data obtained with Revman 5.2 (Nordic Cochrane Center, Copenhagen, Denmark) and Stata 12.0 software (Stata Corporation, College Station, TX, USA). The Mantel-Haenszel method was used to calculate the pooled odds ratio (OR) and 95% confidence intervals (CIs).ResultsSixteen studies with a total of 1823 participants met the inclusion criteria, and data were extracted regarding the diagnostic yield of each approach. The ORs for EBUS-TBNA versus transbronchial lung biopsy (TBLB) for the diagnosis of sarcoidosis ranged from 0.26 to 126.58, and the pooled OR was 5.89 (95% CI, 2.20-15.79, P = 0.0004). These findings indicated that EBUS-TBNA provided a much higher diagnostic yield than TBLB. The pooled OR for EBUS-TBNA + TBLB + endobronchial biopsy (EBB) versus TBNA + TBLB + EBB was 1.54 (95% CI, 0.61-3.93, P = 0.36), implying that there was no significant difference between their diagnostic yields. However, clinical heterogeneity was reflected in the nature of the studies and in the operative variables.ConclusionsThe results of this meta-analysis suggest that EBUS-TBNA + TBLB + EBB could be used for the diagnosis of sarcoidosis, if available. At medical centers without EBUS-TBNA, TBNA + TBLB + EBB could be used instead.
| S-EPMC4931269 | biostudies-literature
Project description:BackgroundClinical assessment is the gold standard for diagnosis of bronchiolitis. To date, only one study found LUS (Lung Ultrasound) to be a valuable tool in the diagnosis of bronchiolitis. Aim of this study is to evaluate the accuracy of lung ultrasonography in the diagnosis and management of bronchiolitis in infants.MethodsThis was an observational cohort study of infants admitted to our Pediatric Unit with suspected bronchiolitis. A physical examination and lung ultrasound scans were performed on each patient. Diagnosis and grading of bronchiolitis was assessed according to a clinical and a ultrasound score. An exploratory analysis was used to assess correspondence between the lung ultrasound findings and the clinical evaluation and to evaluate the inter-observer concordance between the two different sonographs.ResultsOne hundred six infants were studied (average age 71 days). According to our clinical score, 74 infants had mild bronchiolitis, 30 had moderate bronchiolitis and two had severe bronchiolitis. 25 infants composed the control group. Agreement between the clinical and sonographic diagnosis was good (90.6%) with a statistically significant inter-observer ultrasound diagnosis concordance (89.6%). Lung ultrasound permits the identification of infants who are in need of supplementary oxygen with a specificity of 98.7%, a sensitivity of 96.6%, a positive predictive value of 96.6% and a negative predictive value of 98.7%. An aberrant ultrasound lung pattern in posterior chest area was collected in 86% of infants with bronchiolitis. In all patients clinical improvement at discharge was associated with disappearance of the previous LUS findings. Subpleural lung consolidation of 1 cm or more in the posterior area scan and a quantitative classification of interstitial syndrome based on intercostal spaces involved bilaterally, good correlate with bronchiolitis severity and oxygen use.ConclusionsThe lung ultrasound findings strictly correlate with the clinical evaluations in infants with bronchiolitis and permit the identification of infants who are in need of supplementary oxygen with high specificity. Scans of the posterior area are more indicative in ascertaining the severity of bronchiolitis.Trial registrationClinical Trial Registration NCT01993797.
| S-EPMC4494717 | biostudies-literature
Project description:The study aimed to compare the molecular profiles of metastatic, locally advanced, and resected primary pancreatic adenocarcinoma at the genomic and transcriptomic levels. DNA and mRNA were extracted from endoscopic ultrasound-guided fine needle aspiration-biopsy material of primary tumors from 397 patients, and they were subsequently analyzed by targeted deep sequencing and RNAseq.
2024-01-18 | GSE253260 | GEO
Project description:Background and aimEsophageal duplication cysts (EDCs) are rare congenital malformations, often discovered incidentally during endoscopy or on computed tomography (CT) scans. The role of endoscopic ultrasound (EUS) and CT scan in the diagnosis of these lesions and indications for surgical treatment are underreported. The aim of this study was to investigate these topics in a cohort of patients.Materials and methodsBetween January 2001 and October 2020, 82 patients had a suspicion of esophageal duplication cyst on endoscopic ultrasound. Thirty four of these patients were referred for surgical enucleation of the lesion, but three patients were lost to follow-up. At the end, 31 patients, who underwent surgical treatment for their suspected EDC were included in this study. Clinical features, EUS findings, CT images, surgical treatment, and outcome were collected from hospital health records. CT images were re-evaluated by a chest radiologist. Type of surgery, surgical complications, and final histological diagnosis were reported.Results and conclusionThe patients referred for surgery were younger (p = 0.0001) and had larger lesions (> 2 cm; p = 0.005) than the patients who had non-operative follow-up. From thirty-one operated patients, eighteen (58%) had post-operative histological diagnosis of duplication cyst. On EUS the final histological diagnosis was correct in 58% (18/31) of all the operated cases and on CT scan 57% (17/30). CT scan misdiagnosed three of the EDCs but found two leiomyomas correctly. None of these patients developed malignancy. According to this study, neither EUS without fine-needle biopsy nor CT scan alone can differentiate EDCs from other mediastinal masses.
| S-EPMC11568022 | biostudies-literature