The value of sonographically guided fine-needle aspiration in the diagnosis of small lymph

Abstract

Background:To analyze the diagnostic value of ultrasound-guided fine-needle aspiration (FNA) biopsy for lymph nodes with short-axis diameters ≤1 cm and to investigate whether the short-axis diameter influences the results of FNA biopsy. Methods:The cytological results of ultrasound-guided FNA lymph node biopsies in 1,242 cases treated at our hospital between December 2015 and June 2017 were retrospectively analyzed. The results were compared with the final diagnostic results of the cases (988 cases had core-needle biopsies, and 254 cases were followed-up for more than six months) to explore the diagnostic value of ultrasound-guided FNA for small lymph nodes.Results: The sensitivities, specificities and accuracies of ultrasound-guided FNA were 99.6%, 99.5% and 99.5% for small lymph nodes with short-axis diameters ≤1 cm and 97.2%, 94.4% and 96.4% for lymph nodes with short-axis diameters >1 cm, respectively. No significant differences were detected between the two groups (P>0.05). Lymph nodes with short-axis diameters ≤1 cm were divided into three groups according to the following diameters: 0.7 cm ≤ short-axis diameter ≤1 cm, 0.5 cm ≤ short-axis diameter <0.7 cm, and short-axis diameter <0.5 cm. The sensitivities of ultrasound-guided FNA for these three groups were 99.6%, 99.5% and 98.0% respectively; the specificities were 99.5%, 99.0% and 98.0%, respectively; and the accuracies were 99.8%, 99.3% and 99.0%, respectively. The differences in accuracy between the three groups were significant (P<0.05), while the differences in sensitivity and specificity were not significant (P>0.05). Conclusions:The diagnostic results of ultrasound-guided FNA for small lymph nodes are not affected by the short-axis diameter. For lymph nodes with short-axis diameters ≤1 cm, the accuracy decreases as the short-axis diameter decreases, but FNA still has a high diagnostic accuracy for these small lymph nodes.

Serial FNA allows direct sampling of malignant and infiltrating immune cells in patients with B‐cell lymphoma receiving immunotherapy

“…We also describe in our Materials and Methods section the use of ultrasound-guided FNA to help to target and sample small and shrinking nodules while maintaining optimal cell sample collection. 4,[13][14][15] Although a team in 2001 did report serial fine-needle sampling of metastatic melanoma samples, this study provides data for a concert of clinical trial studies; expands the discussion of the techniques used to acquire and analyze the samples, including single-cell sequencing techniques; and references and demonstrates the sum of the results obtained from these techniques. 12 Limitations of performing serial FNA to support clinical trials of this type include 1) the need to have welltrained cytopathologists readily available to see patients and perform FNA biopsies within the time schedule windows of the clinical trials and 2) the fact that nodules selected for FNA biopsy can decrease in size after therapies begin and make sample collection more difficult and challenging.…”

“…Ultrasound guidance was used to sample small or difficult to palpate lymph node targets. 4,[12][13][14] This proved important when samples were being collected during these studies because 1) the clinical teams wanted to biopsy smaller nodes that were detected on scans and were barely palpable or nonpalpable and 2) some of the target lymph nodes decreased in size and became nonpalpable during the clinical trials. Rapid onsite evaluation (ROSE) was not used in order to preserve as much cellular material as possible for analysis and cellular profiling.…”

“…In clinical practice, fine-needle aspiration (FNA) is routinely used to easily and reliably sample and diagnose tumors with a combination of morphology, flow cytometry, ultrasound guidance, and additional ancillary studies. [1][2][3][4] Now FNA is beginning to expand into the clinical trial setting. [5][6][7][8][9] FNA offers the ability to directly sample tumors and their immune microenvironments with a procedure that is minimally disruptive to the tissue, cost-effective, and well tolerated by patients.…”

Investigation of the value of ultrasound-guided core needle biopsy from pathologic lymph nodes to the diagnosis of lymphoma

“…In addition, in this method the obtained sample is unchanged and the cells do not become compressed, which is very important for pathological evaluation. [ 19 ]…”