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• W2116048229 abstract "Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) allows sampling of heretofore inaccessible and challenging abdominal adenopathy easily and safely. EUS-FNA success limited to this subset of patients has not been uniquely studied. Describe our experience with EUS-FNA in a large cohort of patients presenting with abdominal adenopathy. Consecutive patients undergoing EUS-FNA for abdominal adenopathy from April 2004 through August 2009 were included. Patient demographics, indications, EUS findings, and final cytology diagnosis were recorded. Subsequent clinic visits, imaging, and results of any further biopsies or surgeries served as the reference standard in patients found to have benign cytology. A total of 230 lymph nodes were biopsied in 225 patients. Median age was 60 years (range 23-88 years) and 57% were male and 76% Caucasian. The indications for EUS included abdominal mass seen on imaging (41%), known primary cancer or possible cancer recurrence in (28%), and incidental adenopathy on imaging (21%). Common locations of nodes included peripancreatic (19%), porta hepatis (18%), celiac axis (18%), hepatoduodenal (14%) and gastrohepatic (11%). Median node diameter was 19 mm (range 3-59). The 22 gauge EUS-FNA needle was used in 87% of cases (the 25 gauge needle used in the remainder), and the median number of passes was 3 (range 1-7). Adequate specimens were obtained in 200/230 nodes (87%) and the most common diagnoses based on cytology were: benign/reactive (50%), adenocarcinoma (20%), lymphoma (8%), neuroendocrine tumor (3%), and granulomatous inflammation (2%). Flow cytometry was submitted on 63 (27%) of the specimens, and the material submitted was adequate for flow in 92% of these specimens. Flow cytometry helped to confirm the diagnosis or subtype lymphomas in 84% of these cases. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were 96%, 99%, 99%, 97%, and 98% respectively for EUS-FNA. Based on EUS imaging alone, malignant nodes were more likely to be larger in diameter (17 mm vs. 26 mm, p<0.001), have a round shape (p=0.002), well defined borders (p=0.04), and hypoechic echotexture (p<0.001). 7 complications were noted and all were post procedural pain, none of which required hospitalization. EUS-FNA allows excellent tissue acquisition in abdominal lymphadenopathy that is adequate for performing sophisticated analyses such as flow cytometry when contemplating lymphomas and/or other malignancies. Our study supports the use of traditional EUS criteria to determine malignant appearing nodes. The large number of patients included in our study with impressive performance characteristics and safety profile highlights the effectiveness of EUS-FNA for ascertaining the etiology of abdominal lymphadenopathy." @default.
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• W2116048229 date "2011-04-01" @default.
• W2116048229 modified "2023-09-27" @default.
• W2116048229 title "Sa1462 What Is the Yield of EUS-FNA in Abdominal Adenopathy?" @default.
• W2116048229 doi "https://doi.org/10.1016/j.gie.2011.03.196" @default.
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