EUS-guided fine-needle aspiration in the mediastinum

Barawi, Mohammed; Gress, Frank G.

doi:10.1067/mge.2000.110721

Cited by 18 publications

(7 citation statements)

References 47 publications

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“…Obtaining tissue from thoraco-abdominal lymph nodes is always difficult, but EUS-FNA has a greater yield and has been shown to be superior to percutaneous CT- and ultrasound-guided FNA [2,8,9]. There is evidence that EUS-FNA can supplant other more invasive diagnostic procedures, such as diagnostic mediastinoscopy, laparoscopy, thoracotomy and laparotomy [3,5,10].…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence that EUS-FNA can supplant other more invasive diagnostic procedures, such as diagnostic mediastinoscopy, laparoscopy, thoracotomy and laparotomy [3,5,10]. Even very small lesions, as small as 5 mm in diameter, may be biopsied using EUS-FNA, which is not usually possible using other more widely available methods, including CT-guided biopsy or FNA [7,8]. EUS-FNA is much cheaper and a less invasive procedure than mediastinoscopy, which has traditionally been the gold standard for obtaining tissue from mediastinal nodes and has a very low rate of serious complications [1,2].…”

Section: Discussionmentioning

confidence: 99%

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Use of Ancillary Techniques in Improving the Yield of Samples Obtained at Endoscopic Ultrasound-Guided Fine Needle Aspiration of Thoracic and Abdominal Lymph Nodes

Loya

Nadeem²,

Yusuf³

2014

Acta Cytologica

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Objectives: Thoracic and abdominal lymph nodes may be enlarged in a variety of disorders. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a well-established technique for sampling such nodes, but samples obtained are small, which may make definitive diagnosis difficult. We conducted a retrospective review to determine the contribution of ancillary techniques, such as special histochemistry (SHC), immunohistochemistry (IHC) and flow cytometry, in increasing the diagnostic yield of EUS-FNA carried out at our institution. Study Design: Between November 2005 and December 2012, 278 patients underwent EUS-FNA of enlarged thoracic and abdominal nodes at our institution. All specimens obtained were subjected to rapid on-site evaluation. Data were reviewed in all patients requiring ancillary techniques for definitive diagnosis. Results: Ancillary techniques were performed in 111 of 278 cases. IHC was performed in 24, flow cytometry in 3 and SHC staining in 84. IHC and SHC aided in reaching a definitive diagnosis in 19 of 24 and 3 cases, respectively. Flow cytometry led to a definitive diagnosis in 3 cases. A total of 80 cases were also submitted to culture for tuberculosis with 6 positive for Mycobacterium tuberculosis. Conclusions: Ancillary studies in EUS-FNA of thoracic and abdominal lymph nodes can significantly improve the yield of EUS-FNA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of Ancillary Techniques in Improving the Yield of Samples Obtained at Endoscopic Ultrasound-Guided Fine Needle Aspiration of Thoracic and Abdominal Lymph Nodes

Loya

Nadeem²,

Yusuf³

2014

Acta Cytologica

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“…EUS-FNA is very useful for intra-abdominal and some intrathoracic deep-seated lesions in close proximity to the gastrointestinal tract, and even for deep pelvic lesions sampled through the rectum that are relatively inaccessible by other standard image-guided techniques. Small lesions, as small as 5 mm in diameter, may be biopsied using EUS-FNA, which is not usually possible using other methods, including CT-guided biopsy or FNA [7,8]. In contrast to some of the traditional procedures, both EUS- and EBUS-FNA can be performed repeatedly for surveillance purposes.…”

Section: Diagnostic Utility Of Eus/ebus-fnamentioning

confidence: 99%

Endoscopic/Endobronchial Ultrasound-Guided Fine Needle Aspiration and Ancillary Techniques, Particularly Flow Cytometry, in Diagnosing Deep-Seated Lymphomas

Jin

Wakely²

2016

Acta Cytologica

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Evaluation of deep-seated lymphomas by fine-needle aspiration (FNA) can be challenging due to their reduced accessibility. Controversy remains as to whether FNA and ancillary techniques can be used to diagnose deep-seated lymphomas reliably and sufficiently for clinical management. Most published studies are favorable that endobronchial ultrasound (EBUS)/endoscopic ultrasound (EUS)-FNA plays an important role in the diagnosis of deep-seated lymphomas. The addition of ancillary techniques, particularly flow cytometry, increases diagnostic yield. While subclassification is possible in a reasonable proportion of cases, the reported rates of successful subclassification are lower than those for lymphoma detection/diagnosis. The diagnostic limitation exists for Hodgkin's lymphoma, grading of follicular lymphoma, and some T-cell lymphomas. The role of FNA in deep-seated lymphomas is much better established for recurrent than primary disease. It remains unclear whether the use of large-sized-needle FNA or a combination of core needle biopsy and FNA improves subclassification. It is important for cytopathologists to have considerable understanding of the WHO lymphoma classification and develop a collaborative working relationship with hematopathologists and oncologists. As EUS/EBUS-FNA techniques advance and sophisticated molecular techniques such as next- generation sequencing become possible, the role of FNA in the diagnosis of deep-seated lymphomas will possibly increase.

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“…For mediastinal lymph nodes in the subcarina, aorticopulmonary window and paraesophageal regions unreachable by mediastinoscopy, EUS-FNA is the least invasive means of biopsy. 1 The sensitivity and specificity of EUS-FNA vary but are generally favorable. 2,3 Some of the variation in diagnostic yield may be due to location of the node or mass, technical difficulty of the aspiration or level of experience of the endoscopist.…”

Section: Eus-fna Of Mediastinal Nodesmentioning

confidence: 99%

Utility of Immediate Evaluation of Endoscopic Ultrasound-Guided Transesophageal Fine Needle Aspiration of Mediastinal Lymph Nodes

Emery

Savides²,

Behling³

2004

Acta Cytologica

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EUS-guided fine-needle aspiration in the mediastinum

Cited by 18 publications

References 47 publications

Use of Ancillary Techniques in Improving the Yield of Samples Obtained at Endoscopic Ultrasound-Guided Fine Needle Aspiration of Thoracic and Abdominal Lymph Nodes

Use of Ancillary Techniques in Improving the Yield of Samples Obtained at Endoscopic Ultrasound-Guided Fine Needle Aspiration of Thoracic and Abdominal Lymph Nodes

Endoscopic/Endobronchial Ultrasound-Guided Fine Needle Aspiration and Ancillary Techniques, Particularly Flow Cytometry, in Diagnosing Deep-Seated Lymphomas

Utility of Immediate Evaluation of Endoscopic Ultrasound-Guided Transesophageal Fine Needle Aspiration of Mediastinal Lymph Nodes

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