ABSTRACT
Background and aim: Endoscopic ultrasound [EUS] and the subsequent EUS-guided fine needle aspirate [EUS-FNA] represent a major breakthrough in interventional methods especially for sampling suspicious-appearing lymph nodes. Therefore, we aimed to evaluate the diagnostic yield EUS-FNA in setting of a given abdominal and/or mediastinal lymph nodes. Also, to detect the echo- features that may predict lymph node malignant potentials
Methods: Between January 2014 and May 2015, all consecutive patients with intra-abdominal and/or mediastinal lymphadenopathy were enrolled. EUS-FNA was carried out and the aspirate then sent for cytological and histological studies and Immune stains [IHC]. EUS-FNA results were categorized into benign or malignant. The gold- standards for final diagnosis were the postoperative pathological results or the follow-up course
Results: during the period of the study, a total of 86 patients [50 males, mean age 57.62 +/- 8.47] were enrolled. No major complications were reported. The main proven final diagnoses of the LNs were pancreatic cancer [34.88%, n=30], and cholangiocarcinoma [12.8%, n=11] and 75.6% [n=65] were malignant. The sensitivity, specificity, and accuracy rates of EUS-FNA were 95.38%, 100%, and 95.5%, respectively [No false positive cases]. The multivariate Binary logistic regression revealed that only the echo-texture [odds ratio 29.8; P=0.003] and short axis diameter of the lymph nodes [odds ratio 1.6; P=0. 025] are the most predictors of malignant potentiality
Conclusions: EUS-FNA is an accurate and safe method for diagnosis of abdominal and mediastinal lymphadenopathy