The Role of Endoscopic Ultrasound‐Guided Fine‐Needle Biopsy (EUS‐FNB) for the Diagnosis of Gastric Linitis Plastica

Aims Gastric Linitis plastica (GPL) is a difuse type of carcinoma which accounts for 3–19 % of gastric adenocarcinomas. It is characterised by a thickening and stiffening of the gastric wall. The condition is often difficult to be diagnosed endoscopically- the endoscopic appearance could be unremarkable and the mucosal biopsies are often negative for malignant cells due to cancer infiltrating the submucosa and proper muscle layer. The aim of this study was to assess the performance of EUS‐FNB using 22G Franseen-tip needle for the diagnosis of gastric linitis plastic after negative histology, obtained during upper endoscopy.

Methods Data was collected retrospectively from January 2019 to October 2020. All the patients had diffuse or focal gastric wall thickening detected on abdominal ultrasound and/or CT-scan. They were referred for EUS- guided biopsy after failure of gastroscopy to establish tissue diagnosis. Patients underwent endoscopic ultrasound with a linear scope (Fujifilm EG-580UT) and fine needle biopsy using 22G Acquire needle (Boston Scientific Corp.).

Results Eight patients (4 men, 4 women) underwent EUS-guided biopsy of the gastric wall during the study period. Sufficient tissue for histologic diagnosis was obtained in 7 cases. In six of the patients we proved gastric adenocarcinoma. In one- gastric wall infiltration from serous papillary ovarial adenocarcinoma. In one of the patients EUS-FNB was negative, malignant cells were detected in the peritoneal fluid after diagnostic paracentesis. No complications were observed during the first 48 hours and after 30 days follow-up.

Conclusions It is well known that EUS is a valuable tool for both detecting and staging linitis plastica. Our study proves thatEUS – FNB using 22G Franseen-tip needle is safe and highly effective technique for histologic diagnosis of GLP and we recommend it especially in cases when biopsies obtained during gastroscopy are negative.

Citation Karagyozov P ¹, Zhecheva I, Tishkov I. eP375 THE ROLE OF ENDOSCOPIC ULTRASOUND‐GUIDED FINE‐NEEDLE BIOPSY (EUS‐FNB) FOR THE DIAGNOSIS OF GASTRIC LINITIS PLASTICA. Endoscopy 2021; 53: S218.

Publication History

Article published online:
19 March 2021