The role of endoscopic ultrasound-guided fine needle aspiration (eus-fna) for the diagnosis of intra-abdominal lymphadenopathy of unknown origin

Jason Korenblit, Archana Anantharaman, David E Loren, Thomas E Kowalski, Ali A Siddiqui
Journal of Interventional Gastroenterology 2012, 2 (4): 172-176
23687604

BACKGROUND AND AIMS: The diagnosis of intra-abdominal lymphadenopathy of is difficult, especially when no primary lesion has been identified. We aimed to evaluate the diagnostic yield of EUS-FNA cytology in patients with enlarged intra-abdominal lymph nodes of unknown etiology.

PATIENT AND METHODS: 147 patients with abdominal lymphadenopathy on imaging in whom EUS-FNA was performed with a 22-gauge needle. Performance characteristics of EUS-FNA including the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were compared between the 2 groups.

RESULTS: AThe location of the enlarged lymph nodes was the celiac axis (8.2%), peri-gastric (34%), peri-pancreatic (25.2%), peri-portal (27.9%), and other intra-abdominal locations (4.8%). The median number of EUS-FNA passes was 5. The final diagnosis were lymphoma in (n=27), metastatic adenocarcinoma (n=44) patients, other miscellaneous malignancies (n=22) and benign disease (n=54). The sensitivity, specificity, and accuracy of EUS-FNA were 89.7, 98.3, and 93.5% respectively. A false positive FNA result was present in only 1 case (0.7%); false negative FNA results were present in eight cases (5.8%). Lymph node morphologic features of roundness, echogenicity, and homogeneity on EUS were not a predictor of lymph node malignancy.

CONCLUSION: In a retrospective cohort trial, EUS-FNA was found to be highly accurate and safe in diagnosing patients with intra-abdominal lymphadenopathy of unknown etiology.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23687604
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"