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
| Autor: | Vasilis Chatzikyriakos, Roozbeh Shams, Per Hedenström, Catarina Lewerin, Riadh Sadik |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Endoscopic ultrasound
medicine.medical_specialty Lymphadenopathy Medicine (miscellaneous) RC799-869 Endosonography 03 medical and health sciences 0302 clinical medicine Fine-needle biopsy Interquartile range Endoscopic ultrasound-guided fine-needle aspiration Biopsy medicine Radiology Nuclear Medicine and imaging Sampling (medicine) Internal medicine Lymph node medicine.diagnostic_test business.industry Gastroenterology Diseases of the digestive system. Gastroenterology medicine.disease RC31-1245 digestive system diseases Lymphoma Fine-needle aspiration medicine.anatomical_structure 030220 oncology & carcinogenesis Original Article 030211 gastroenterology & hepatology Radiology Sarcoidosis business |
| Zdroj: | Clinical Endoscopy Clinical Endoscopy, Vol 54, Iss 5, Pp 722-729 (2021) |
| ISSN: | 2234-2443 2234-2400 |
| Popis: | 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.Conclusions: 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. |
| Databáze: | OpenAIRE |
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