Endoscopic ultrasound-guidedfine-needle aspirationof portal vein thrombosis in patients with chronic liverdisease and suspicion of hepatocellular carcinomaAntonio Z. Gimeno Garciaa, Jose R. Apariciob, Angel Barturenc, Miguel Morenoa, David Nicolas-PerezaandEnrique QuinteroaBackgroundDifferentiation between benign and malignant portal vein thrombosis (PVT) in the setting of a hepatocellularcarcinoma (HCC) is of paramount importance. Histological analysis is usually not carried out because of potential severe sideeffects of the percutaneous approach. Endoscopic ultrasound-guidedfine-needle aspiration (EUS-FNA) may be safer and mayguide the clinical management of patients with HCC.ObjectiveTo describe the feasibility of the EUS-FNA in a series of patients with HCC and PVT.Materials and methodsA chart review of patients with PVT was performed from 2014 to 2016 in three tertiary care hospitals ofSpain. Patients with chronic liver disease and PVT with a suspicion of HCC referred for EUS-FNA were included. The impact ofthe EUS-FNA was assessed by comparing staging following the Barcelona Clinic Liver Cancer algorithm (BCLC) before and afterEUS-FNA.ResultsOf 104 patients with PVT and chronic liver disease, 23 were considered candidates for EUS-FNA. Eight patients werereferred for EUS-FNA. The technique was feasible in seven patients and FNA was positive in six patients. No side effects werereported. EUS-FNA upstaged six out of seven (85.7%) patients: one patient BCLC stage B, two patients BCLC stage A, andthree patients in whom the HCC was not diagnosed before EUS-FNA of the PVT. A benign PVT was found in the explant of theonly patient with a negative PVT.ConclusionEUS-FNA is a valuable technique in selected patients with chronic liver disease with PVT. It is feasible, safe, andmay alter the clinical management in these patients. Eur J Gastroenterol Hepatol 00:000–000Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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