EUS-guided fine-needle aspiration combined with flow cytometry and immunocytochemistry in the diagnosis of lymphoma

• Published in: Gastrointestinal endoscopy 2001-04, Vol.53 (4), p.485-491
• Main Authors: Ribeiro, Afonso, Vazquez-Sequeiros, Enrique, Wiersema, Lisa M., Wang, Kenneth K., Clain, Jonathan E., Wiersema, Maurits J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Biopsy, Needle - methods; Digestive system. Abdomen; Endoscopy, Digestive System - methods; Female; Flow Cytometry; Humans; Immunohistochemistry; Investigative techniques, diagnostic techniques (general aspects); Lymph Node Excision; Lymph Nodes - diagnostic imaging; Lymphatic Diseases - diagnosis; Lymphoma - classification; Lymphoma - diagnosis; Lymphoma - diagnostic imaging; Lymphoma - pathology; Male; Medical sciences; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Ultrasonic investigative techniques; Ultrasonography
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1067/mge.2001.112841

Background: Limited information is available regarding the use of EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis of lymphoproliferative disorders. The aim of this study was to evaluate the yield of this technique in the primary diagnosis of lymphoma. Methods: The records were reviewed of 38 consecutive patients with GI lesions and/or enlarged lymph nodes identified on imaging studies that raised a suspicion of lymphoma who underwent EUS-FNA of lymph nodes or the gut wall. Final diagnosis was based on clinical follow-up, imaging studies, or surgical findings. Results: Twenty-three patients with lymphoma and 15 patients with benign disease or reactive lymphadenopathy were identified. The overall sensitivity, specificity, and accuracy of EUS-FNA cytology with flow cytometry/immunocytochemistry (FC/IC) for the diagnosis of lymphoma were, respectively, 74%, 93%, and 81%. When comparing patients who had EUS-FNA with FC/IC versus those who had EUS-FNA without FC/IC, sensitivity was 86% versus 44% ( p = 0.04), specificity was 100% versus 90% (not significant), and accuracy was 89% versus 68% (not significant). Conclusion: EUS-FNA can provide cytology specimens diagnostic for lymphoma. Selective use of FC/IC in patients with suspected lymphoma improves the yield of EUS-FNA and may guide diagnostic evaluation and treatment decisions. (Gastrointest Endosc 2001;53:485-91.)