Dataset Information

High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative Study.

ABSTRACT:

Background/aims

The diagnostic work-up of lymphadenopathy is challenging but important to determine the correct therapy. Nevertheless, few studies have addressed the topic of endosonography (EUS)-guided tissue acquisition in lymphadenopathy. Therefore, we aimed to evaluate the accuracy and safety of EUS-guided fine-needle biopsy sampling (EUS-FNB) in intrathoracic and intraabdominal lymphadenopathy.

Methods

In a tertiary care center, patients with lymphadenopathy referred for EUS-guided sampling were included prospectively from 2014 to 2019 (NCT02360839). In all cases, EUS-FNB (22 gauge) and EUS-guided fine-needle aspiration (EUS-FNA) (25 gauge) were performed. The patients were randomized to the first needle pass with FNB or FNA. Study outcomes were the diagnostic accuracy and adverse event rate.

Results

Forty-eight patients were included (median age: 69 years [interquartile range, 59-76]; 24/48 females [50%]). The final diagnoses were metastasis (n=17), lymphoma (n=11), sarcoidosis (n=6), and inflammatory disease (n=14). The diagnostic performance of the two modalities was comparable, including a high sensitivity for metastatic nodes (EUS-FNB: 87% vs. EUSFNA: 100%, p=0.5). The sensitivity for lymphoma was borderline superior in favor of EUS-FNB (EUS-FNB: 55% vs. EUS-FNA: 9%, p=0.06). No adverse events were recorded.

Conclusion

In lymphadenopathy, both EUS-FNB and EUS-FNA are safe and highly sensitive for metastatic lymph node detection. Lymphoma diagnosis is challenging regardless of the needle used.

SUBMITTER: Hedenstrom P

PROVIDER: S-EPMC8505168 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative Study.

Hedenström Per P Chatzikyriakos Vasilis V Shams Roozbeh R Lewerin Catarina C Sadik Riadh R

Clinical endoscopy 20210304 5

<h4>Background/aims</h4>The diagnostic work-up of lymphadenopathy is challenging but important to determine the correct therapy. Nevertheless, few studies have addressed the topic of endosonography (EUS)-guided tissue acquisition in lymphadenopathy. Therefore, we aimed to evaluate the accuracy and safety of EUS-guided fine-needle biopsy sampling (EUS-FNB) in intrathoracic and intraabdominal lymphadenopathy.<h4>Methods</h4>In a tertiary care center, patients with lymphadenopathy referred for EUS- ...[more]

PMID: 33657782

Similar Datasets

Project description:Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is an effective technique for qualitative diagnosis of space occupying lesions in and around the wall of the digestive tract. At present, there are many studies on EUS-FNA via the upper gastrointestinal route, while there are few studies on EUS-FNA via the lower gastrointestinal route, especially for Chinese patients with pelvic mass. Therefore, this study sought to evaluate the value of transrectal EUS-FNA in the qualitative diagnosis of pelvic masses in Chinese patients. The clinical data of 35 patients with pelvic masses who underwent EUS-FNA at our hospital were collected from September 2014 to December 2021. Among these patients, 10 underwent surgical treatment after EUS-FNA, and a diagnosis was made based on a pathologic evaluation. The EUS-FNA biopsy results were compared to the final diagnostic results to calculate the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of EUS-FNA in the diagnosis of malignant pelvic mass. For the 10 patients who underwent surgery, the final diagnoses were based on the pathologic findings of surgical specimens, and for the 25 patients who did not undergo surgery, the final diagnoses were based on the malignant pathological results of EUS-FNA or clinical follow-up results. Among the 35 patients, 12 had benign lesions, including pelvic abscesses, cysts, and inflammatory masses, and 23 had malignant lesions, including mesenchymal tumors, leiomyosarcomas, teratomas, and malignant tumors with pelvic metastases. There were no complications resulting from the biopsy punctures. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EUS-FNAs for the diagnosis of malignant pelvic masses were 91.3% (21/23), 100.0% (12/12), 100.0% (21/21), 85.7% (12/14), and 94.3% (33/35), respectively. EUS-FNA is a safe and effective method for the qualitative diagnosis of pelvic masses, and has good clinical application value.

Project description:ObjectiveTo evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses.Materials and methodsThis was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass.ResultsOf the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System.ConclusionUS-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

Dataset Information

High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative Study.

Background/aims

Methods

Results

Conclusion

Publications

High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets