EUS characteristics of celiac ganglia with cytologic and histologic confirmation

BackgroundCeliac ganglia have not been previously identified by EUS.ObjectiveTo assess whether celiac ganglia can be detected by EUS and to define their characteristics.DesignRetrospective review followed by prospective study.MethodsRetrospective characterization was performed of all celiac ganglia that were incidentally identified by EUS-guided FNA or tru-cut needle biopsy from January 2004 to October 2005. We also prospectively assessed if these structures could be visualized in consecutive patients undergoing curved linear-array EUS.PatientsSeven patients with celiac ganglia diagnosed by EUS-guided FNA (n = 7) and/or tru-cut needle biopsy (n = 1) were reviewed. Twenty-two patients were prospectively evaluated by curved-linear-array EUS.SettingsDivision of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.Main Outcome MeasurementsEUS features and detection rate of celiac ganglia.ResultsAll retrospectively evaluated celiac ganglia were identified anterior to the aorta, slightly to the left, and cephalad to the celiac artery take-off, and medial to the left adrenal gland. The mean distance from the celiac artery take-off was 10 mm (±3 mm); mean size was 13 mm (±3 mm) by 6 mm (±2 mm). They appeared as hypoechoic and multilobulated structures with hyperechoic strands. Celiac ganglia with sonographic features as described above were identified in 16 of 22 prospectively evaluated patients (73%).LimitationsSmall number of patients; no tissue confirmation of prospectively evaluated patients.ConclusionsCeliac ganglia can be identified with curved linear-array EUS in the majority of patients. Their typical EUS appearance allows distinction from celiac lymph nodes.