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
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...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2021-09-01
|
| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2020-283.pdf |
| _version_ | 1797428919454924800 |
|---|---|
| author | Per Hedenström Vasilis Chatzikyriakos Roozbeh Shams Catarina Lewerin Riadh Sadik |
| author_facet | Per Hedenström Vasilis Chatzikyriakos Roozbeh Shams Catarina Lewerin Riadh Sadik |
| author_sort | Per Hedenström |
| collection | DOAJ |
| description | 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. EUS-FNA: 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. |
| first_indexed | 2024-03-09T09:05:48Z |
| format | Article |
| id | doaj.art-1ecf1343dde44e40a85df753f2192946 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T09:05:48Z |
| publishDate | 2021-09-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-1ecf1343dde44e40a85df753f21929462023-12-02T10:23:23ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432021-09-0154572272910.5946/ce.2020.2837488High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative StudyPer Hedenström0Vasilis Chatzikyriakos1Roozbeh Shams2Catarina Lewerin3Riadh Sadik4 Division of Medical Gastroenterology, Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Division of Medical Gastroenterology, Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, SwedenBackground/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. EUS-FNA: 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.http://www.e-ce.org/upload/pdf/ce-2020-283.pdfendoscopic ultrasound-guided fine-needle aspirationendosonographyfine-needle biopsylymphadenopathy |
| spellingShingle | Per Hedenström Vasilis Chatzikyriakos Roozbeh Shams Catarina Lewerin Riadh Sadik 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 Clinical Endoscopy endoscopic ultrasound-guided fine-needle aspiration endosonography fine-needle biopsy lymphadenopathy |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | endoscopic ultrasound-guided fine-needle aspiration endosonography fine-needle biopsy lymphadenopathy |
| url | http://www.e-ce.org/upload/pdf/ce-2020-283.pdf |
| work_keys_str_mv | AT perhedenstrom highsensitivityofendoscopicultrasoundguidedfineneedleaspirationandendoscopicultrasoundguidedfineneedlebiopsyinlymphadenopathycausedbymetastaticdiseaseaprospectivecomparativestudy AT vasilischatzikyriakos highsensitivityofendoscopicultrasoundguidedfineneedleaspirationandendoscopicultrasoundguidedfineneedlebiopsyinlymphadenopathycausedbymetastaticdiseaseaprospectivecomparativestudy AT roozbehshams highsensitivityofendoscopicultrasoundguidedfineneedleaspirationandendoscopicultrasoundguidedfineneedlebiopsyinlymphadenopathycausedbymetastaticdiseaseaprospectivecomparativestudy AT catarinalewerin highsensitivityofendoscopicultrasoundguidedfineneedleaspirationandendoscopicultrasoundguidedfineneedlebiopsyinlymphadenopathycausedbymetastaticdiseaseaprospectivecomparativestudy AT riadhsadik highsensitivityofendoscopicultrasoundguidedfineneedleaspirationandendoscopicultrasoundguidedfineneedlebiopsyinlymphadenopathycausedbymetastaticdiseaseaprospectivecomparativestudy |