TITLE

A Descriptive Analysis of EUS-FNA for Mediastinal Lymphadenopathy: An Emphasis on Clinical Impact and False Negative Results

AUTHOR(S)
Hernandez, Lyndon V.; Mishra, Girish; George, Suku; Bhutani, Manoop S.
PUB. DATE
February 2004
SOURCE
American Journal of Gastroenterology;Feb2004, Vol. 99 Issue 2, p249
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been shown to accurately diagnose mediastinal lymph node pathology. We investigated the clinical impact of EUS-FNA in the management of patients with mediastinal lymphadenopathy, and determined the nature and clinical consequences of false negative results.METHODS: We analyzed a cohort of patients who were found to have mediastinal lymph nodes by EUS and underwent FNA. The diagnostic standard included FNA cytology, histopathology, and clinical follow-up.RESULTS: Sixty EUS-FNAs of mediastinal lymph nodes were performed on 59 patients (mean age 61 years old, 74.5% men) over a 24-month period. Prior to EUS, 20 (34%) patients had known malignancy. The most frequent indication for EUS was failed diagnosis by bronchoscopy (54%). EUS-FNA of lymph nodes showed malignant cells in 38%. The diagnostic accuracy of EUS-FNA was 84%. Among the 47 patients who were available for follow-up, EUS-FNA provided new information by changing the clinical diagnosis, and subsequently changed the management in 18 (38%) patients. The false negative rate was 20% (95% exact CI, 8.4–31.6%). Two of the 7 false negative cases received empiric chemoradiation without tissue diagnosis, and 4 received palliative treatment for advanced malignancy.CONCLUSION: The most common indication for EUS-FNA of the mediastinum in our institution is nondiagnostic transbronchial FNA. EUS-FNA is a valuable diagnostic method for sampling mediastinal lymph nodes and affecting management. False negative results do not appear to delay appropriate treatment or adversely affect clinical outcome.
ACCESSION #
14816734

 

Related Articles

  • Endobronchial Ultrasound: First Choice for the Mediastinum. Herth, Felix J. F. // Endoscopic Ultrasound;Nov2013, Vol. 2 Issue 4, p179 

    An introduction to the periodical is presented in which the author discusses various articles within the issue on topics which include use of Computed tomography (CT), positron emission tomography (PET), and efficacy of transbronchial needle aspiration (TBNA) technology for mediastinal lymph nodes.

  • An Early Comparison between Endoscopic Ultrasound-guided Fine-needle Aspiration and Mediastinoscopy for Diagnosis of Mediastinal Malignancy. Serna, Dan L.; Aryan, Henry E. // American Surgeon;Oct1998, Vol. 64 Issue 10, p1014 

    Presents an assessment and comparison of mediastinoscopy with endoscopic ultrasound (EUS) combined with fine-needle aspiration (FNA) biopsy in evaluating mediastinal diseases. Histology of biopsied mediastinal masses in suspected bronchogenic carcinoma; Major weakness of both approaches;...

  • Rescue Endoscopic Ultrasound (EUS)-Guided Trucut Biopsy Following Suboptimal EUS-Guided Fine Needle Aspiration for Mediastinal Lesions. Chang-Min Cho; Al-Haddad, Mohammad; LeBlanc, Julia K.; Sherman, Stuart; McHenry, Lee; DeWitt, John // Gut & Liver;Mar2013, Vol. 7 Issue 2, p150 

    Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and Trucut biopsy (TCB) are sensitive techniques for diagnosing mediastinal lesions, but it is unclear how either one or both should be used to obtain a pathologic diagnosis. The objective of our study was to evaluate...

  • ADDITIONAL DIAGNOSTICS WITH THE ULTRASOUND BRONCHOSCOPE FOR THE TRANSOESOPHAGEAL ASSESS. Stojanovic, Zoran; Andreo, Felipe; Centeno, Carmen; Santos, José Sanz; Bonet, Gloria; Castellà, Eva; Campins, Federico; Llatjòs, Mariona; Manzano, Juan Ruiz // Turkish Respiratory Journal / Solunum Dergisi;2013 Supplement, Vol. 15, p42 

    Aim: To evaluate the role of transoesophageal endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) in patients with mediastinal or paramediastinal lesions. Materials and Methods: Prospective study which included 279 consecutive patients (221 men; mean age 63, SD...

  • EUS to the Rescue? Eloubeidi, Mohamad A.; Hawes, Robert H.; Hoffman, Brenda J.; Johnson, David // American Journal of Gastroenterology;Feb2001, Vol. 96 Issue 2, p595 

    This study prospectively evaluated the role of transesophageal endoscopic endosonography-guided fine needle aspiration (EUS-FNA) in consecutive patients with suspected but yet undiagnosed lung cancer where bronchoscopic methods failed. Patients were included in the study if lung cancer was...

  • Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of peripancreatic tuberculous lymphadenitis. Itaba, Soichi; Yoshinaga, Shigetaka; Nakamura, Kazuhiko; Mizutani, Takahiro; Honda, Kuniomi; Takayanagi, Ryoichi; Yamada, Kinya // Journal of Gastroenterology;Jan2007, Vol. 42 Issue 1, p83 

    The percentage of patients with atypical extrapulmonary forms of tuberculosis has been increasing. Among extrapulmonary tuberculosis cases, tuberculosis of the pancreas and peripancreatic lymph nodes is a rare clinical entity. Here, we present a case of peripancreatic tuberculous lymphadenitis...

  • Training in endoscopic ultrasound-guided fine needle aspiration. Paquin, Sarto C. // Endoscopic Ultrasound;Feb2014, Vol. 3 Issue 1, p12 

    The article offers information related to the training of endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) for removal of malignancies. Topics discussed include recommendations for endosonographers training for EUS-FNA from American Society for Gastrointestinal Endoscopy and...

  • Fine needle aspiration cytology inadequate for assessing cystic pancreatic lesions.  // Hem/Onc Today;7/10/2009, Vol. 10 Issue 13, p22 

    The article discusses a study presented at the 2009 Digestive Disease Week in Chicago, Illinois which examined the utility of endoscopic ultrasound with fine needle aspiration cytology in diagnosing cystic and solid pancreatic lesions.

  • Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Klapman, Jason B.; Logrono, Roberto; Dye, Charles E.; Waxman, Irving // American Journal of Gastroenterology;Jun2003, Vol. 98 Issue 6, p1289 

    : ObjectivesEndoscopic ultrasound-guided fine needle aspiration (EUS-guided FNA) is becoming a preferred modality for diagnosing and staging GI and mediastinal malignancies. Although experts advocate on-site cytopathology assessment for tissue sample adequacy, there are few data to support this...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics