Endoscopic ultrasound-guided fine-needle aspiration in patients with lymphadenopathy suspected of recurrent malignancy after curative treatment

Iwashita, Takuji; Yasuda, Ichiro; Doi, Shinpei; Nakashima, Masanori; Tsurumi, Hisashi; Hirose, Yoshinobu; Takami, Taro; Enya, Mayumi; Mukai, Tsuyoshi; Ohnishi, Takaya; Iwata, Koichi; Tomita, Eiichi; Moriwaki, Hisataka

doi:10.1007/s00535-008-2302-6

Cited by 21 publications

(24 citation statements)

References 22 publications

(28 reference statements)

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“…However, EUS-FNA has many advantages over other techniques [39]: (i) the capability to get a sample from a tiny lesion; (ii) the capability to get a sample of the lesion through a part of the intestinal wall and decrease the risk of needle tract seeding; and (iii) the capability to supply extra information about staging of the disease. In particular, EUS-guided FNA can be carried out in the entire pancreas (the hook and tail included) [16, 17], even for difficult or unreachable regions via the percutaneous access or when the percutaneous route is not indicated [12].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasonography with fine-needle aspiration for histological diagnosis of solid pancreatic masses: a meta-analysis of diagnostic accuracy studies

et al. 2016

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BackgroundPrevious studies have demonstrated that endoscopic ultrasound-fine needle aspiration (EUS-FNA) is a reliable tool for diagnosing pancreatic lesions; however, the reported sensitivity and specificity vary greatly across studies. The aim of this study was to pool the existing literature and assess the overall performance of EUS-FNA in the diagnosis of solid pancreatic lesions.MethodsA systematic search of MEDLINE, Cochrane Database for Systematic Reviews, and EMBASE was performed to identify original and review articles published between January 1995 and January 2014 that reported the accuracy of EUS-FNA in the diagnosis of pancreatic masses. Quality of the included studies was assessed using the quality assessment of diagnosis accuracy studies score tool. Meta-DiSc software was used to calculate the pooled sensitivity and specificity, positive and negative likelihood ratios, and to construct the summary receiver operating characteristics curve.ResultsTwenty studies involving a total of 2,761 patients were included in the study. The pooled sensitivity and specificity of EUS-FNA in the diagnosis of solid pancreatic lesions were 90.8 % [95 % confidence interval (CI), 89.4–92 %] and 96.5 % (95 % CI, 94.8–97.7 %), respectively. The positive and negative likelihood ratios were 14.8 (95 % CI, 8.0–27.3) and 0.12 (95 % CI, 0.09–0.16), respectively. The overall diagnostic accuracy was 91.0 %.ConclusionsOur findings suggest that EUS-FNA has high sensitivity and specificity in the diagnosis of solid pancreatic lesions.

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Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasonography with fine-needle aspiration for histological diagnosis of solid pancreatic masses: a meta-analysis of diagnostic accuracy studies

et al. 2016

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“…Needless to say, careful follow-up is necessary after endoscopic resection, but it is difficult for current diagnostic imaging equipment to differentiate whether slightly enlarged lymph nodes, as in the present case, are non-malignant or metastatic [12]. Iwashita et al [13] analyzed the enlarged lymph nodes of 62 patients and reported EUS-FNA sensitivity to be 97% with a specificity of 100%. EUS-FNA was also effective in the present case; therefore, we believe that EUS-FNA can be of assistance in making an accurate diagnosis for patients with enlarged lymph nodes.…”

Section: Discussionmentioning

confidence: 77%

A case of lymph node metastasis following a curative endoscopic submucosal dissection of an early gastric cancer

et al. 2011

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Currently in Japan, differentiated gastric submucosal invasive cancers \500 lm (SM1) with negative lymphovascular involvement are included in expanded pathological criteria for curative endoscopic treatment. This is based on a retrospective examination of surgical resection cases in which patients suitable for such expanded criteria were determined to have a negligible risk of lymph node metastasis. We performed endoscopic submucosal dissection on a 65-year-old male with early gastric cancer in April 2005, and pathology revealed a welldifferentiated adenocarcinoma, 21 9 10 mm in size, SM1 invasion depth and negative lymphovascular invasion as well as tumor-free margins, so the case was diagnosed as a curative resection. This case, however, resulted in lymph node metastasis that was diagnosed by endoscopic ultrasonography with fine-needle aspiration biopsy in May 2009. Distal gastrectomy with D2 lymph node dissection was then performed, confirming lymph node metastasis from the original gastric cancer.

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“…Although it might be possible to confirm the pathological diagnosis by EUS-FNA, its sensitivity and specificity in patients with lymphadenopathy suspected of recurrent malignancy is low and has a risk of dissemination in the case of extrinsic tumors. Hence, we performed laparoscopic surgery to resect the tumor as a total excisional biopsy [10]. In the present case, we performed three EMRs, and every pathological examination revealed moderately differentiated adenocarcinoma, which indicates that it is difficult to pathologically predict the primary tumor of metastatic LN.…”

Section: Discussionmentioning

confidence: 86%

A case of late lymph node metastasis after three endoscopic mucosal resections of intramucosal gastric cancers

et al. 2014

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We describe a patient with solitary lymph node (LN) metastasis after three endoscopic mucosal resections (EMRs) in which a gastrointestinal stromal tumor was difficult to differentiate from the carcinoid and lymphoma tumors. A 77-year-old man underwent three EMRs at 62, 72, and 75 years of age, and all resections were determined to be curative. However, 2 years after the last EMR, screening abdominal ultrasonography detected a 20-mm solitary tumor at the lesser curvature of the upper stomach. Laparoscopic tumor resection confirmed the pathological diagnosis. Intraoperative pathological diagnosis showed that the adenocarcinoma was compatible with recurrence of gastric cancer; thus, total gastrectomy with D1 lymphadenectomy was performed. Metastasis was not recognized by pathological examination but was detected by preoperative radiological examinations of the LN. We report a rare recurrence case after several EMRs of intramucosal gastric cancers.

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Endoscopic ultrasound-guided fine-needle aspiration in patients with lymphadenopathy suspected of recurrent malignancy after curative treatment

Cited by 21 publications

References 22 publications

Endoscopic ultrasonography with fine-needle aspiration for histological diagnosis of solid pancreatic masses: a meta-analysis of diagnostic accuracy studies

Endoscopic ultrasonography with fine-needle aspiration for histological diagnosis of solid pancreatic masses: a meta-analysis of diagnostic accuracy studies

A case of lymph node metastasis following a curative endoscopic submucosal dissection of an early gastric cancer

A case of late lymph node metastasis after three endoscopic mucosal resections of intramucosal gastric cancers

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