EUS-guided FNA

In the last 10 years, EUS-FNA has matured into a highly valuable technique for acquisition of cytologic specimens from the chest, the abdomen, and the pelvis. In skilled hands, with expert cytopathology, EUS-FNA should be able to provide a cytologic diagnosis in over 80% of malignant lesions, with complication rates similar to alternative procedures such as CT or TUS-guided needle aspirations. It still has a high likelihood of providing diagnostic tissue samples in patients when other sampling techniques have failed or when alternative imaging cannot clearly visualize or access the lesion to be sampled. In lesions where other sampling techniques are possible, EUS-FNA may still be advantageous in obtaining specimens of pancreatic masses or when diagnostic EUS is going to be used in the patient. The greatest potential impact of EUS-FNA appears to be in non-small-cell lung cancer staging, where EUS-FNA can affect the management of these patients by cytologically diagnosing advanced, non-operable disease. EUS-FNA is a technically demanding procedure requiring a fundamental understanding of diagnostic EUS.