EUS-guided Fine Needle Aspiration (EUS-FNA) Versus EUS-guided Fine Needle Biopsy (EUS-FNB) for Diagnosis of Subepithelial Tumors

Background: Preoperative pathologic diagnosis of subepithelial tumor (SET) can improve clinical decision making. Although EUS-guided fine needle aspiration (FNA) is currently considered the standard method for sampling SET, its diagnostic yield is generally suboptimal. EUS-guided fine needle biopsy (FNB) of SET is safe and feasible with adequate histology obtained.

Objective: To compare the diagnostic accuracy of EUS-FNA and EUS-FNB.

Inclusion Criteria:

• Esophageal, gastric, or duodenal SET over 2 cm
• Hypoechoic lesion including 4th layer on EUS

Exclusion Criteria:

• SET with characteristic findings such as lipoma, vessels, or ectopic pancreas
• bleeding or rupture of SET
• platelet count <50,000 or prothrombin time INR > 1.3