Ultrasound-guided fine needle aspiration cytology of carcinoma involving the intra-abdominal oesophagus.

Ultrasound-guided fine needle aspiration cytology (FNAC) of carcinoma of the intra-abdominal oesophagus was attempted on 21 patients with a 21 G spinal needle using a percutaneous anterior epigastric approach. The results were compared with those of endoscopic biopsy and brush cytology. The ultrasound-guided FNAC had a positive yield in 20/21 (95.2%) compared with 18/21 (85.7%) for endoscopic biopsy and 18/21 (85.7%) for brush cytology (P greater than 0.59). The combination of US-guided FNAC with endoscopic biopsy and the brush cytology achieved a positive yield in 21/21 (100%) whereas combining endoscopic biopsy and brush cytology produced a positive yield of 19/21 (90.5%). Two patients developed temporary epigastric pain. We recommend US-guided FNAC as a safe and effective technique that can be used alone or as an adjunct to endoscopic procedures for the diagnosis of carcinoma of the intra-abdominal oesophagus.