31/08/2025                                                                            
                                    
                                                                            
                                            > Case Study: High Risk Endoscopic Ultrasound (EUS) Guided Fine Needle Aspiration Biopsy at Vishwaraj Hospital
> Performed by: Dr. Narendra Chopde
Introduction
With the installation of Endoscopic Ultrasound (EUS) facilities at Vishwaraj Hospital, we were privileged to perform the first EUS-guided Fine Needle Aspiration Biopsy (FNAB) at the center. This case highlights the complexity of managing a large splenic lesion and the crucial role of EUS in obtaining a safe and accurate diagnosis.
Case Presentation
* Patient Profile: 42-year-old female
* Symptoms: Abdominal pain, anorexia, nausea, and intermittent vomiting for the last 2 months
* Co-morbidities- ASD with immunocompromised status
Initial Imaging:
* Ultrasound (USG): Splenomegaly with a large splenic lesion (?Lymphoma)
* CT Abdomen & Pelvis: Heterogeneously enhancing, highly vascular lesion (10.3 x 8.6 x 8.6 cm) arising from the splenic hilum, encasing splenic vessels, forming collaterals, and abutting the pancreatic tail, left kidney, anterior abdominal wall, and stomach
Plan 
* PET- CT, Immunohistochemistry
Procedure
* Planned Intervention: Endoscopic Ultrasound (EUS) guided Fine Needle Aspiration Biopsy
EUS Findings:
* Lesion appeared solid, heterogeneous, and highly vascular
* Multiple collateral vessels surrounding the lesion posed significant risk of bleeding
* Careful mapping was required to identify a safe site for tissue acquisition
Challenges:
* Extensive vascularity
* Risk of hemorrhage due to surrounding collaterals
* Limited tissue acquisition zones
Outcome:
* Successful targeted biopsy performed under EUS guidance
* Minimal complications during and after the procedure
Histopathology (HPE) Report
* Findings: Low-grade epithelial neoplasm
* Additional Background: Patient also has Atrial Septal Defect (ASD) with immunocompromised status
Consult Dr. Narendra Chopde – For expert Gastroenterology Care .
📞 +919518795469 
🌐 https://www.drnarendrachopde.com/
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