scholarly journals Impact of endoscopic ultrasound-guided fine needle aspiration of small lymph nodes

2016 ◽  
Vol 07 (02) ◽  
pp. 051-054
Author(s):  
Narendra S. Choudhary ◽  
Rinkesh Kumar Bansal ◽  
Rajesh Puri ◽  
Vijay Bodh ◽  
Gaurav Kumar Patil ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Study Cohort ◽  
Short Axis ◽  
Axis Ratio ◽  
Fine Needle ◽  
Significant Difference

Abstract Background: There is very limited literature on results of fine needle aspiration (FNA) of small (defined as ≤1 cm at long and short axis) lymph nodes, particularly in the setting of pyrexia of unknown origin (PUO). Methods: The study was conducted from July 2014 to December 2015 at a tertiary care center. A total of 34 endoscopic ultrasound (EUS)-guided FNAs in 33 patients were done for lymph nodes ≤1 cm at long and short axis and these were included in the analysis. Results: The study cohort comprised 33 patients; 23 males and 10 females, mean age of 58 ± 12 years. Indication of FNA was to look for malignancy (n = 15), PUO (n = 16), unexplained weight loss (n = 1), and presence of lymphadenopathy in prospective liver donor (n = 1). The FNA was taken from mediastinal nodes (n = 20, 14 subcarinal) and abdominal (n = 14, 8 at porta). The mean size of lymph nodes was 87 ± 11 mm at large axis and 68 ± 17 mm at short axis. A total of 3 (8.8%) FNAs were nondiagnostic (inadequate material). The cytopathologic diagnosis was malignancy in 8 (23.5%), granulomatous change in 8 (23.5%), and reactive lymphadenopathy in 15 (44.1%). Thus, EUS-guided FNA of these small nodes changed the management decisions in 44% of cases (one patient had tubercular lymphadenopathy at two sites). The 22-gauge EUS FNA needle was used in majority of patients (n = 26). There was no significant difference between pathologic (malignant and granulomatous) and reactive lymph nodes regarding size at long or short axis, ratio of long and short axis, hypoechogenicity, and sharply defined borders. Conclusion: EUS-guided FNA of small lymph nodes showed pathological enlargement in 44% of cases.

scholarly journals Diagnostic adequacy and safety of endoscopic ultrasound-guided fine-needle aspiration in patients with lymphadenopathy in a large cohort

2018 ◽  
Vol 06 (04) ◽  
pp. E421-E424 ◽  
Author(s):  
Rinkesh Bansal ◽  
Narendra Choudhary ◽  
Saurabh Patle ◽  
Mahesh Gupta ◽  
Chitranshu Vashishtha ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Large Population ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Study Cohort ◽  
Short Axis ◽  
Fine Needle ◽  
Significant Difference

Abstract Background and study aims The role of endoscopic-ultrasound (EUS) guided fine-needle aspiration (FNA) in patients with lymphadenopathy in terms of diagnostic adequacy and safety in large population is not well defined. The aim of this study was to evaluate diagnostic adequacy and safety of EUS-FNA in patients with lymphadenopathy. Patients and methods Retrospective study from October 2010 to September 2015 at tertiary care center in Delhi-NCR. We analyzed data from 1005 EUS- FNAs of lymph nodes. Results The study cohort comprised 1005 lymph nodes in 865 patients; 68 % were males, mean age was 50 ± 14 years. Indications of FNA were to look for etiology of pyrexia of unknown origin or staging of malignancy mainly. FNA was taken from mediastinal nodes (n = 528, 52.5 %) and intra-abdominal nodes (n = 477, 47.5 %). Median size of nodes at long axis and short axis was 17 (12 – 25.7) and 10 (8 – 15) mm respectively. Adequate material by FNA was obtained in 92.8 % cases. The cytopathologic diagnosis were malignancy in 153 (15.2 %), granulomatous change in 452 (42 %), and reactive lymphadenopathy in 328 (35.6 %). There was statistically significant difference seen between groups with pathological and reactive lymph nodes regarding size at long and short axis, hypoechoic nature, well defined borders and presence of necrosis and calcification. Procedure-related adverse effects were encountered in 6 patients (0.8 %). Four patients had mild mucosal bleeding in chronic liver disease patients and two had mild hepatic encephalopathy related to sedation. Conclusion EUS-FNA of lymph nodes has good diagnostic adequacy and safety.

scholarly journals Comparison of endoscopic ultrasound-guided fine-needle aspiration by capillary action, suction, and no suction methods: a randomized blinded study

2017 ◽  
Vol 05 (10) ◽  
pp. E980-E984 ◽  
Author(s):  
Rinkesh Bansal ◽  
Narendra Choudhary ◽  
Rajesh Puri ◽  
Saurabh Patle ◽  
Suraj Bhagat ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Randomized Study ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Hospital ◽  
Capillary Suction ◽  
Capillary Action ◽  
Fine Needle

Abstract Background and study aim Different types of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) techniques are used in clinical practice; the best method in terms of outcome has not been determined. The aim of the study was to compare the diagnostic adequacy of aspirated material, and the cytopathological and EUS morphological features between capillary action, suction, and no-suction FNA methods. Patients and methods This was a prospective, single-blinded, randomized study conducted at a tertiary care hospital. Patients were randomized to the three groups: capillary action, suction, and no suction. A total of 300 patients were included, with 100 patients in each arm. Results A total of 300 patients (195 males) underwent EUS-FNA of 235 lymph nodes and 65 pancreatic masses (distribution not statistically different between the groups). The mean age was 52 ± 14 years. A 22 gauge needle was used in the majority (93 %) of procedures. There was no statistical difference between the three groups regarding lymph node size at the largest axis and ratio, type of needle, echo features, echogenicity, calcification, necrosis, shape, borders (lymph nodes), number of passes, and cellularity. Diagnostic adequacy of the specimen was 91 %, 91 %, and 94 % in the capillary, suction, and no suction groups, respectively (P = 0.67). Significantly more slides and blood clots were generated by the suction method compared with the other methods. Conclusion The capillary action, suction, and no suction methods of EUS-FNA are similar in terms of diagnostic adequacy of the specimen. The suction method has the disadvantages of causing more bleeding and generating more slides.

scholarly journals Distribution of Various Malignant Lesions in Lymph Node Cytology – A 1 Year Population Based Study from a Tertiary Care Centre in North-East India

2021 ◽  
Vol 8 (17) ◽  
pp. 1090-1094
Author(s):  
Badrinath Venkatesh ◽  
Khagokpam Ambala Devi ◽  
Soram Gayatri Gatphoh
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Undifferentiated Carcinoma ◽  
Metastatic Tumour ◽  
Fine Needle ◽  
North East ◽  
Malignant Lesions

BACKGROUND Lymph nodes (LN) are an integral component of the immune system. Enlarged lymph nodes are a prime target for fine needle aspiration (FNA). Lymph nodes greater than 1 to 2 cm are an immediate source of concern. Lymphadenopathy is a common presenting symptom in various diseases. Fine needle aspiration cytology (FNAC) confirms the presence of metastatic disease and gives a clue regarding its nature and origin of primary malignancy. In many metastatic malignancies, FNAC may be the only tool for diagnosis and further management of the patients. We intend to assess the cytomorphological patterns of both primary tumour and metastatic tumour in a lymph node. METHODS A retrospective study was conducted in the Department of Pathology, RIMS, Imphal, over a period of one year from January 1, 2018 to December 31, 2018. Five hundred and fifty-five lymph nodes were aspirated, out of which 99 cases turned out to be malignant lesions. Giemsa and PAP stained FNAC slides were collected and reviewed. Data entry and analysis were done by using SPSS version 21. RESULTS Out of 99 cases, 88.9 % were metastatic tumours and 11.1 % were of primary lymphoproliferative disorders. Thirty three percent of malignant lymphadenopathy were found in fifth decade. Undifferentiated carcinoma constituted around 32.3 % of all the cases of malignant lymphadenopathy. Cervical group of lymph nodes were involved in 46.5 % of cases. CONCLUSIONS FNAC has proved to be a useful tool in diagnosing malignancy with good certainty. FNAC of lymph nodes prevents complications associated with lymph node biopsy. KEYWORDS FNAC, Lymph Node, Undifferentiated Carcinoma, Squamous Cell Carcinoma

scholarly journals Pull vs. wet: rendimiento diagnóstico y calidad de las muestras de las PAAF guiadas por USE en las masas sólidas del páncreas

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Cecilia Curvale ◽  
Ignacio Málaga ◽  
Paloma Rojas Saunero ◽  
Viviana Tassi ◽  
Enrique Martins ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Double Blind Study ◽  
Cell Block ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Fine Needle ◽  
Significant Difference

Differential diagnosis of pancreatic masses is challenging. The endoscopic ultrasound-guided fine-needle aspiration method with the highest diagnostic yield has not been established. It was realized a prospective, randomized, double-blind study of the endoscopic ultrasound-guided fine-needle aspiration in solid lesions of the pancreas to compare and evaluate diagnostic yield and aspirate quality between wet and pull technique. Forty-one patients were enrolled. The wet technique presented a sensitivity, a specificity, a positive and negative predictive value, and a diagnostic accuracy of 58.3%, 100%, 100%, 25% and 63.4%, respectively. In the capillary technique they were: 75%, 100%, 100%, 35.7% and 78.1%, respectively. Comparing the diagnostic yield between both techniques, there was no statistically significant difference (McNemar’s test p = 0.388). Regarding the cellularity of the specimen, both in cytology and the cell block samples, no significant difference was observed between the techniques (p = 0.84 and 0.61, respectively). With respect to contaminating blood in the specimen, there was no difference in cytology samples (p = 0.89) and no difference in cell block samples (p = 0.08). The suitability of cytology samples for diagnosis was similar in both techniques (wet = 57.5% and capillary = 56.7%, p = 0.94) and there was no difference in cell block samples (wet = 75% and capillary = 66.1%, p = 0.38). In this study we did not observe differences in diagnostic yield or sample quality. Since both techniques are effective, we suggest the simultaneous and alternate use of both methods.

scholarly journals Predictors of Malignancy and Recommended Follow-Up for Patients with Negative Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspected Pancreatic Lesions

2009 ◽  
Vol 23 (4) ◽  
pp. 279-286 ◽  
Author(s):  
Bret J Spier ◽  
Eric A Johnson ◽  
Deepak V Gopal ◽  
Terrence Frick ◽  
Michael M Einstein ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Tertiary Care ◽  
Malignant Lesion ◽  
Needle Aspiration ◽  
Long Term Outcome ◽  
Fine Needle ◽  
Pancreatic Malignancy ◽  
Risk Of Cancer

BACKGROUND: Endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) can characterize and diagnose pancreatic lesions as malignant, but cannot definitively rule out the presence of malignancy. Outcome data regarding the length of follow-up in patients with negative or nondiagnostic EUS-FNA of pancreatic lesions are not well-established.OBJECTIVE: To determine the long-term outcome and provide follow-up guidance for patients with negative EUS-FNA diagnosis of suspected pancreatic lesions based on imaging predictors.METHODS: A retrospective review of patients undergoing EUS-FNA for suspected pancreatic lesions, but with negative or nondiagnostic FNA results was conducted at a tertiary care referral medical centre. Patient demographics, EUS imaging characteristics and follow-up data were examined.RESULTS: Seventeen of 55 patients (30.9%) with negative/nondiagnostic FNA were subsequently diagnosed with pancreatic malignancy. The risk of cancer was significantly higher for patients who had associated lymph nodes on EUS (P<0.001) and vascular involvement on EUS (P=0.001). The mean time to diagnosis in the group with false-negative EUS-FNA diagnosis was 66 days. The true-negative EUS-FNA patients were followed for a mean of 403 days after negative EUS-FNA results without the development of malignancy.CONCLUSION: For patients undergoing EUS-FNA for a suspected pancreatic lesion, a negative or nondiagnostic FNA does not provide conclusive evidence for the absence of cancer. Patients for whom vascular invasion and lymphadenopathy are detected on EUS are more likely to have a true malignant lesion and should be followed closely. When a patient has been monitored for six months or more with no cancer being diagnosed, there appears to be much less chance that a pancreatic malignancy is present.

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