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Endoscopic Ultrasound with Aspiration


Medical editor Lars Aabakken MD
Gastroenterologist

Oslo University Hospital
Norway

General

The location of the tumor or lymph node in the mediastinum determines whether an endoscopic ultrasound-guided fine needle aspiration (EUS) from the esophagus or endobronchial ultrasound (EBUS) should be performed.

EUS with aspiration of lymph nodes in the mediastinum is a minimally invasive examination whereby patients can avoid examinations associated with more risk. With EUS, the mediastinal lymph nodes can be sampled at most levels of the mediastinum. 

Indication

  • Enlarged lymph nodes and/or tumor in the mediastinum raising suspicion of a serious lung disease, cancer in the esophagus or stomach. 

Goal

  • Establish a diagnosis 
  • Stage determination

Equipment

  • Endoscope with accessories
  • Needle for puncture
  • Equipment for preparation of cytology specimen

Preparation

  • The patient lies on his/her side and is mildly sedated.
  • Application of local anesthesia in the throat.  

Implementation

  • The scope is inserted into the esophagus via a mouthpiece. 
  • The lymph nodes are visualized using ultrasound.
  • The aspiration needle is inserted through the work channel of the scope and by ultrasound guidance, into the lymph node.
  • Using back-and-forth movements with the needle, cells are sucked out of the lymph node.
  • The material is prepared and assessed by a cytologist.
  • The procedure can be repeated until representative material is obtained.

Follow-up

  • The patient can return home the same day.
  • It may take up to one week before the results are available.

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