scholarly journals Differential Diagnosis of Periportal Adenopathy Based on Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS-FNA)

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S62-S62
Author(s):  
M Esebua
Keyword(s):  
Differential Diagnosis ◽  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Group 2 ◽  
Malignant Diagnosis ◽  
Positive Lymph Nodes ◽  
Group 1

Abstract Introduction/Objective Endoscopic ultrasound guided fine-needle aspiration is a safe and accurate diagnostic procedure for abdominal lymphadenopathy. Goal of this study is to evaluate the utility of EUS-FNA in two groups of patients with periportal lymphadenopathy: group 1 with diagnosis of malignancy and group 2 with no known malignant diagnosis. Methods/Case Report This is a retrospective study of 74 patients in our database with enlarged periportal lymph nodes detected on cross sectional imaging of the abdomen. All patients underwent EUS-FNA with 22-gauge needle. Three passes were performed for each lymph node detected. Median size of periportal lymph nodes was 19.8 mm (ranging from 5 to 59 mm). 2 groups were compared: group 1 with known malignancy and group 2 with no known malignancy. All patients were clinically followed 6-12month from the procedure. Results (if a Case Study enter NA) 25 of the 74 (34%) patients had malignant diagnosis. The types of neoplasia detected were lymphoma (3), metastatic adenocarcinoma (16), metastatic acinar cell carcinoma (1) and metastatic neuroendocrine tumor (5). 42 of 74 patients (57%) had negative fine-needle aspiration diagnosis: 40 patients had reactive lymph node diagnosis, 2 patients had granulomatous inflammation diagnosis. 2(1%) of 74 cases had atypical diagnosis, 5(7%) cases were unsatisfactory due to inadequate material obtained during procedure. Sensitivity of the procedure is 45.8% and, specificity is 100%. Positive predictive value (PPV) is 100% and negative predictive value (NPV) is 78.7%. EUS-FNA can detect positive lymph nodes as small as 1 cm, however, this method can also miss positive lymph nodes up to size of 3.5 cm which probably due to the uneven involving of the nodes by tumor cells. Lymph nodes 3.5cm and larger are more likely to be malignant, however in differential diagnosis of small lymph nodes (1 cm in length) they were noT statistically significant difference between the pathologic and benign lymph nodes. Conclusion EUS-FNA is effective method for investigating periportal lymphadenopathy with known or unknown malignancy.

Results of preoperative ultrasound guided fine needle aspiration biopsy of solitary thyroid nodules as compared with the histology

2001 ◽  
Vol 40 (05) ◽  
pp. 148-154 ◽  
Author(s):  
U. Wartner ◽  
E. Kresnik ◽  
H. J. Gallowitsch ◽  
M. Heinisch ◽  
H. P. Dinges ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Summary Aim: The goal of this study was to assess the accuracy and limitations of ultrasound guided fine-needle aspiration biopsy (ug-FNAB) of solitary thyroid nodules. Methods: The ug-FNAB results of 538 patients with solitary thyroid nodules, who afterwards underwent thyroid surgery, were compared retrospectively with the histology. Patients with multinodular goiter were excluded from the study. Ug-FNAB was performed on growing and/or hypoechoic and/or hypofunctional nodules. The ug-FNAB results were grouped as follows: group 1: malignant (n = 44); group 2: malignancy cannot be ruled out (n = 173); group 3: non-malignant (n = 296), group 4: inadequate (n = 25). Results: When the cytological results of group 1 and group 2 were interpreted os being malignant and those of group 3 as being benign, sensitivity, specificity and accuracy of ug-FNAB were 96.7%, 65.8% and 69.5% respectively. The 62 thyroid carcinomas (TO biopsied presented in 59 cases a suspicious or malignant cytology (95.2%). The smallest TC diagnosed by ug-FNAB had a diameter of 0.5cm and 36.4% of all papillary TC ≤ 1 cm displayed stage pT4. The histology verified a TC in 18 cases out of the 173 ug-FNABs in group 2. Non-malignant ug-FNABs were confirmed by histology in 294 patients (99.3%) in group 3. In 4.65% of the ug-FNABs inadequate material was aspirated. Conclusion: Nodules with non-suspicious ug-FNAB results can be safely followed-up by sonography, as the cytological diagnoses were verified in more than 99% by histology. Papillary TC can be diagnosed with ug-FNAB very accurately. As stage pT4 was present in more than one third of patients with papillary TC ≤ T cm, ug-FNAB is also recommended for thyroid nodules 0.5-1 cm in diameter located adjacent to the thyroid capsule. However, microfollicular proliferations remain the limitation of ug-FNAB, as the cytology cannot distinguish between benign adenoma and follicular TC.

Lymph Node Metastases of Differentiated Thyroid Carcinoma: Does Serum Anti-Tg Antibodies or TSH Level Influence Tg measurement in Fine Needle Aspiration Washouts?

2021 ◽  
Author(s):  
Sara Donato ◽  
Joana Maciel ◽  
Paula Font ◽  
Helder Simões ◽  
Susana Prazeres ◽  
...  
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Fine Needle Aspiration ◽  
Lymph Node Metastases ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Fine Needle ◽  
Node Metastases ◽  
Group 2 ◽  
Group 1

Abstract Introduction: Thyroglobulin evaluation in the washout of fine-needle aspiration (FNA-Tg) is an accurate diagnostic method of lymph node metastases (LNM) of differentiated thyroid carcinoma (DTC). Serum anti-thyroglobulin antibodies (AATg) may cause falsely low serum Tg values, but their effect on FNA-Tg has not been well established. There are also concerns about the possibility that suppressed TSH results in false-negative FNA-Tg. Our objectives were to evaluate the effect of serum AATg and TSH level on FNA-Tg of LNM of DTC and to determine the presence of AATg on the washout of fine needle aspiration (FNA-AATg). Methods: Retrospective analysis of patients who underwent FNA-Tg assay in LNM of DTC. The sample was divided in two groups according to the presence of serum AATg at the time of FNA-Tg evaluation (Group 1: positive AATg, n =47; Group 2: negative AATg, n =50). Results: There was no significant difference in the FNA-Tg between the two groups ( p =0.066), although it was lower in Group 1 (1428 ng/mL) than in Group 2 (14842 ng/mL). FNA-Tg was able to identify 10.3% LNM of DTC that would not be diagnosed based solely on cytology. FNA-AATg evaluation was positive in 12.8% of the Group 1 patients and did not seem to interfere with FNA-Tg value ( p =0.732). There were no differences in the median FNA-Tg measurements between those on levothyroxine suppressive therapy and those on substitutive therapy ( p =0.800). Conclusion: FNA-Tg assay appears to be a good diagnostic tool even in patients with positive serum AATg and those under suppressive levothyroxine therapy.

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