西村 庸夫¹, 中西 正¹, 棟田 三保¹, 浦岡 佳子¹, 赤松 興一²

Nobuo NISHIMURA¹, Tadashi NAKANISHI¹, Miho MUNETA¹, Yoshiko URAOKA¹, Kouichi AKAMATSU²

¹松山市民病院内科, ²愛媛大学医学部第三内科

¹Department of Internal Medicine, Matsuyama Shimin Hospital, ²The Third Department of Internal Medicine, Ehime University Medical School

キーワード : Fine needle aspiration biopsy, Capsule of hepatoma, Experimental studies, Negative pressure

Echo aspiration biopsy was performed using a 21 G needle with a small diameter in 33 nodules of intrahepatic small lesions. The biopsy tissue and resected specimen were compared in false negative cases. Our results showed that when aspiration was initiated before the capsule in hepatoma cases with a thick capsule, the needle tip was occluded with cirrhotic tissue and the capsule and tumor tissue did not enter into the needle. Therefore, it is necessary for the needle to puncture the tumor before initiating aspiration biopsy.
Regarding the fine needle aspiration biopsy, the performance capability of the needle itself and the procedure for puncturing have been discussed much, whereas how the aspired specimens should be treated has been little discussed. The specimens, when allowed to stand only for a second, become fragmented. We note that the causes for such fragmentation includes an influx of air from the tip of the needle immediately following the biopsy. In tissue sampling, even if consistent specimens are obtained, they are often found to become fragmented by rapid influx of air from the tip of the needle. To prevent such fragmentation, it is necessary to release negative pressure immediately following withdrawal of the needle. Our method to release the negative pressure has proved to be very effective to ensure satisfactory aspired specimens.