VIDEO PLENARY 2: VID-HPB-02: Endoscopic ultrasound-guided fine needle aspiration from small liver lesions in a case of gallbladder carcinoma

A 52-year-old male presented with nonspecific upper abdominal pain. His ultrasound abdomen revealed gallbladder wall thickening. A contrast (dynamic) computed tomography (CT) abdomen was suggestive of carcinoma gallbladder. He was planned for surgery and a positron emission tomography (PET) CT was done; it showed PET avid lesion of gallbladder small portocaval node with fluorodeoxyglucose uptake. The patient was referred to endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) from lymph node. EUS-guided FNA from portocaval node was suggestive of reactive change. In addition, EUS showed several very small (<5 mm) lesions in the liver parenchyma which were suspicious of metastasis. These lesions were not visible in USG, contrast CT, and PET CT. EUS-guided FNA was taken from these lesions, FNA confirmed metastasis, and a futile surgery could be avoided.