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Thank you for your interest in our practice. We can offer you the most technologically advanced endoscopic procedures in the Inland Northwest. Our focus is on endoscopic oncology and invasive mediastinal staging of lung cancer with endoscopic ultrasound. We also perform routine endoscopies and colon cancer screening.
We work closely with your primary care or specialty care provider. Once our diagnostic or therapeutic procedures have been completed we will communicate with the referring physician who will resume your overall care.
Colon Cancer Screening
We proudly support Newstalk 590's efforts to promote colon cancer screening. Listen to our own radio ad here.
Most insurance carriers pay for screening colonoscopies. You do not even need a referral. Call as directly (509-455-3453) or send us an email (klaus.gottlieb@providence.org) and we will schedule you at a location of your choice for a test which very well may save your life.
To learn more about colonoscopy and colon cancer screening follow this link to a patient information site sponsored by the American Society for Gastrointestinal Endoscopy.
| EUS case of the week |
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Bronchial Carcinoid
This chest CT shows a small right lower lobe mass. Note the intervening normal lung between the lesion and the esophagus |
The tumor can be seen on the radial EUS despite the intervening normal lung |
Visualization of the lesion was even better with the electronic curved-linear array echoendoscope. Note the echo pattern of normal lung |
The EUS-guided FNA cytology revealed features of a typical bronchial carcinoid. This image shows a bronchoscopic view of a right main bronchus carcinoid. Source: Granberg, D. Bronchial Carcinoids. Acta Universitatis Upsaliensis. |
This 40x magnification of the concentrated smear using a Pap stain shows spindle cells, friable cytoplasm, elongated oval nuclei in clusters and as single cells. Courtesy Vann Schaffner, MD. Deaconess Pathology |
The cytokeratin 7 immunostain demonstrates cytoplasmic positivity and proves epithelial differentiation. Chromagranin A and Synaptophysin are also focally positive showing neuroendocrine differentiation. Vann Schaffner, MD |
The TTF-1 immunostain shows nuclear positivity, strongly supporting lung origin. CDX-2 was negative arguing against a metastatic intestinal carcinoid.Vann Schaffner, MD |
This is a 74 year old woman with cirrhosis of the liver who was incidentally found to have a centrally located lung tumor on an abdominal CT scan. She was referred for EUS guided FNA which revealed cytology characteristic of a bronchial carcinoid. Bronchial carcinoids are tumors with a low-grade malignant potential which grow slowly and are associated with a favorable prognosis. There are two subtypes, with the less aggressive type comprising more than 90 percent of cases. In view of the patient's comorbidities no further treatment is planned.
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