P-LUM-12: Diagnostic adequacy and safety of endoscopic ultrasound-guided fine needle aspiration in patients with lymphadenopathy in a large cohort

Abstract

Background and Objectives:

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 the current study was to evaluate diagnostic adequacy and safety of EUS FNA in patients with lymphadenopathy.

Methods:

This was a retrospective study from October 2010 to September 2015 at tertiary care center in Delhi-National Capital Region. We analyzed data of 1005 EUS-guided FNA of the lymph node.

Results:

The study cohort comprised 1005 lymph nodes in 865 patients; 68% were males, mean age was 50 ± 14 years. Indication of FNA was to look for etiology of pyrexia of unknown origin, staging of malignancy, or unexplained weight loss. FNA was taken from mediastinal nodes ( n = 528, 52.5%) and 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 diagnoses were malignancy in 153 (15.2%), granulomatous change in 452 (42%), and reactive lymphadenopathy in 328 (35.6%). Lymph node with a size >1 cm at short axis ( n = 444) was more pathological (70.6%) than size <1 cm ( n = 133, pathological in 43.1%), P = 0.00. There was no statistically difference between the groups regarding type of needle, number of passes, and cellularity. Procedure-related adverse effects were encountered in six 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 the lymph nodes has good diagnostic adequacy and safety.