Open AccessEndoscopic ultrasound and endobronchial ultrasound-guided fine-needle aspiration of deep-seated lymphadenopathy: Analysis of 1338 cases
Author(s) -
Amberly L. Nunez,
Nirag Jhala,
Andrew J. Carroll,
Fady M. Mikhail,
Vishnu Reddy,
Rena R. Xian,
Darshana Jhala
Publication year - 2012
Publication title -
cyto journal/cytojournal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.371
H-Index - 27
eISSN - 0974-5963
pISSN - 1742-6413
DOI - 10.4103/1742-6413.95845
Subject(s) - medicine , fine needle aspiration , radiology , papanicolaou stain , endoscopic ultrasound , lymphoma , biopsy , pathology , surgical pathology , cytopathology , stain , fluorescence in situ hybridization , cytology , staining , cancer , biochemistry , chemistry , cervical cancer , gene , chromosome
Background: We retrospectively studied 1338 samples of lymph nodes obtained by endoscopic and endobronchial ultrasound-guided fine needle aspiration biopsy (EUS and EBUS-FNAB) with an objective of characterizing the utility of this diagnostic modality in the assessment of deep-seated lymphadenopathy. The secondary aims were to establish the utility in the diagnosis of lymphoma and to determine the number of passes required to obtain adequate cellularity for flow cytometric analysis. Materials and Methods: On-site assessment was performed by a cytopathologist using Diff-Quik (American Scientific Products, McGraw Park, IL) stain. In addition, Papanicolaou and immunohistochemical stains were performed and additional samples were sent for flow cytometric analyses (n = 145). The final cytologic diagnosis was correlated with surgical pathology diagnosis and/or clinical follow-up. In select cases, fluorescence in situ hybridization analysis with specific probes was performed on Diff-Quik smears. Results: Both morphology as well as ancillary studies (flow cytometry or immunohistochemical stain and/or fluorescence in situ hybridization) show that EUS and EBUS-FNA are effective techniques to detect and stage intrathoracic and intra-abdominal tumors. Operating characteristics show that these are highly sensitive (89%) and specific (100%) techniques for the diagnosis of lymphoma. At least two passes provided an average of 5.66 million cells (range, 0.12-62.32 million) for lymphoma cases. Conclusions: EUS and EBUS-FNA are powerful modalities to stage malignancies and at least two passes can provide adequate cells for flow cytometric analysis. We also demonstrate that fluorescence in situ hybridization analysis can be performed on Diff-Quik-stained and mounted smears