Endoscopic Ultrasound-Guided Liver Lesions Biopsy with Atypical Malignancies- An Alternative to Radiological Biopsy

Background: Endoscopic ultrasound (EUS) is gaining attraction as an alternative method of obtaining biopsies. It offers a more targeted approach for focal lesions in liver especially for those areas which are accessible via EUS-guided method.

Materials and Methods: A total of 8 patients underwent EUS-guided liver lesions biopsies (LLB). EUS Guided LLB was performed using the 22G FNA needle, 2 passes were done with slow pull technique over one minute with 10–15 strokes done in each pass to obtained core samples. The average duration of the procedures ranged from 15–30 minutes.

Results: Out of 8 patients, majority were males. Most of these patients had presented with nonspecific signs and symptoms including weight loss, abdominal pain, jaundice etc. All of the 8 patients had an atypical liver lesions on initial radiological evaluation with inconclusive tumour markers and atypical CT radiological findings. Screening for Hepatitis B and C virus were negative in all of them. EUS guided biopsy performed in them revealed the following diagnosis: well differentiated adenocarcinoma, sarcomatoid carcinoma, neuroendocrine tumour, smooth muscle tumour, metastatic adenocarcinoma, lymphoproliferative disorder and malignant melanoma.

Conclusions: EUS-guided LLB is an alternative new technique for biopsy of liver lesions with suspected atypical malignancies.