The 25G EUS-FNA needle

Dr. VaradarajuluShyam Varadarajulu, MD from the Center for Interventional Endoscopy at Florida Hospital in Orlando, Florida, USA discusses his Original Article “The 25G EUS-FNA needle: Good for onsite but poor for offsite evaluation?”

When rapid onsite cytology evaluation is not available, cell block is used as a technique for off-site interpretation of endoscopic ultrasound-fine needle aspiration (EUS-FNA) specimens. The 25G needle is currently the need of choice for FNA of pancreatic masses. The objective of this study was to determine the ideal number of passes (2 or 4) that will be required to obtain a diagnostic cell block using the 25G needle when sampling pancreatic masses.

The findings will enable centers that do not have access to onsite cytopathology services to perform the correct number of passes so that a diagnosis can be established in a majority of patients undergoing EUS-FNA of pancreatic masses.

In this study, we observed that despite establishing an onsite diagnosis in 100% of patients, a diagnosis could be established by cell block in only 80.6% of patients irrespective of whether 2 or 4 FNA passes were performed. It appears that while the 25G needle may be excellent for establishing onsite diagnosis, it may not be optimal for off-site diagnosis using cell block. The role of larger caliber needles (22 or 19G) in yielding diagnostic cell block must be evaluated in future studies.

Find the abstract for this article online here.

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