Endosonography-guided fine needle aspiration cytology of intra-abdominal lymph nodes with unknown primary in a tuberculosis endemic region
| Autor: | Amit Maydeo, Praveen Mathew, Suryaprakash Bhandari, Mukta Bapat, Vinay Dhir, Andrew Kwek, Vatsala Doctor |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Endoscopic ultrasound
medicine.medical_specialty Tuberculosis Hepatology medicine.diagnostic_test business.industry Gastroenterology Intra-Abdominal Lymph Node medicine.disease digestive system diseases Lymphoma Surgery Fine-needle aspiration Tuberculosis diagnosis Predictive value of tests Biopsy medicine Radiology business |
| Zdroj: | Journal of Gastroenterology and Hepatology. 26:1721-1724 |
| ISSN: | 0815-9319 |
| DOI: | 10.1111/j.1440-1746.2011.06800.x |
| Popis: | Background and Aim: Intra-abdominal lymphadenopathy poses a diagnostic and management challenge in highly endemic regions for tuberculosis. Opting for empirical anti-tuberculosis treatment raises the risk of wrong or delayed treatment. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the procedure of choice for tissue acquisition from peri-luminal lymph nodes. We studied the utility of EUS-FNA in evaluating intra-abdominal lymph nodes of unknown etiology, in the setting of high endemicity of tuberculosis. Methods: Consecutive patients with intra-abdominal lymph nodes of unknown etiology underwent EUS-FNA using a 22-gauge needle. Final diagnosis was made on surgical histology or on 6-months follow-up. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic yield were calculated. Results: Sixty-six patients were included. Final diagnoses were tuberculosis, 35 (53%); metastatic adenocarcinoma, 11 (16.7%); lymphoma, three (4.5%); carcinoid, one (1.5%) and reactive nodes, 16 (24.2%). EUS-FNA provided a diagnosis in 61 patients (92.4%). Sensitivity, specificity, PPV and NPV for diagnosing tuberculosis via EUS-FNA were 97.1%, 100%, 100% and 96.9%, respectively. In 10 (15.2%) patients receiving empirical anti-tuberculosis treatment, the final diagnoses were metastatic adenocarcinoma (5), lymphoma (2), carcinoid (1) and reactive adenopathy (2). Conclusion: Despite being in a highly endemic area, almost half of the patients studied have a non-tuberculosis etiology. EUS-FNA is a safe and accurate procedure for establishing the diagnosis of unexplained intra-abdominal lymphadenopathy. |
| Databáze: | OpenAIRE |
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