Copyright
©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Endosc. Jun 16, 2011; 3(6): 124-128
Published online Jun 16, 2011. doi: 10.4253/wjge.v3.i6.124
Published online Jun 16, 2011. doi: 10.4253/wjge.v3.i6.124
Endoscopic ultrasound with biopsy of omental mass for cholangiocarcinoma diagnosis in cirrhosis
Nathaniel S Rial, Department of Internal Medicine, The University of Arizona, Oro Valley BioV, Mel and Enid College of Public Health, College of Medicine, Tucson, AZ 85724, United States
Kevin B Gilchrist, Department of Pathology, The University of Arizona, College of Medicine, Tucson, AZ 85724, United States
Jeff T Henderson, Arizona Digestive Health Pathology Laboratory, Phoenix, AZ 85006, United States
Achyut K Bhattacharyya, Head of Department of Pathology, Director of Surgical Pathology, The University of Arizona, College of Medicine, Tucson, AZ 85724, United States
Thomas D Boyer, Chairman of Department of Internal Medicine, Department of Gastroenterology, Director of Arizona Liver Institute, The University of Arizona, College of Medicine, Chairman Tucson, AZ 85724, United States
Abdul Nadir, John T Cunningham, Department of Gastroenterology, The University of Arizona, College of Medicine, Tucson, AZ 85724, United States
Author contributions: Rial NS wrote the manuscript; Gilchrist KB, Henderson JT and Bhattacharyya AK provided supportive work, materials and technology; Nadir A and Cunningham JT were responsible for tissue acquisition by ERCP; Boyer T was the Clinical Physician.
Correspondence to: Nathaniel S Rial, MD, PhD, CPH, Department of Internal Medicine, College of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724, United States. nsrial@email.arizona.edu
Telephone: +1-520-626-2761 Fax: +1-520-626-6020
Received: December 31, 2010
Revised: April 13, 2011
Accepted: May 4, 2011
Published online: June 16, 2011
Revised: April 13, 2011
Accepted: May 4, 2011
Published online: June 16, 2011
Abstract
In this report, a patient had a previous diagnosis of cholangiocarcinoma with an extended cholecystectomy. Three years later, he was evaluated for recurrent ascites. The patient had several large volume paracentesis, without evidence of malignant cells. Subsequently, endoscopic ultrasound (EUS) with fine needle aspiration (FNA) of both lymph and omental nodules was utilized. While the lymph nodes were negative for malignancy, the omental nodule was interrogated with multiple antibodies and was found to be positive for neoplasia. EUS with FNA can safely be used in patients with cirrhosis to spare the patient invasive evaluation such as exploratory laparotomy (ex-lap) for diagnosis and staging of cholangiocarcinoma.