Evaluation of performance of EUS‐FNA in preoperative lymph node staging of cancers of esophagus, lung, and pancreas

Peng, HongQi; Greenwald, Bruce D.; Távora, Fábio; Kling, Elaine; Darwin, Peter; Rodgers, William H.; Berry, Anna B.

doi:10.1002/dc.20796

Cited by 21 publications

(10 citation statements)

References 24 publications

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“…This again demonstrates that FNA continues to be a valuable diagnostic tool when assessing lesions by EUS which is consistent with the literature that FNA provides high diagnostic accuracy in most settings. 2,5,19 The number of patients with stromal tumors in our study also gave us valuable information regarding differences between TCB and FNA interpretations. Nineteen patients represented a variety of stromal tumors including gastrointestinal stromal tumor, leiomyoma, myxoid spindle cell neoplasm, leiomyosarcoma, or sclerosing liposarcoma.…”

Section: Discussionmentioning

confidence: 96%

“…[2][3][4][5] The sensitivity of FNA has been shown to range from 45 to 100% (site dependent) with a specificity approaching 100% and diagnostic accuracy ranging from 60 to 95%. [2][3][4][6][7][8] However, there are limitations to EUS-guided FNA. Cytologic interpretation of FNA specimens can be difficult in specimens with obscuring blood, necrotic material, inflammatory cells, or from neoplasms requiring immunohistochemical (IHC) studies for definitive classification.…”

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confidence: 98%

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Comparison of EUS‐guided FNA and Trucut biopsy for diagnosing and staging abdominal and mediastinal neoplasms

Kipp¹,

Pereira²,

Souza³

et al. 2009

Diagnostic Cytopathology

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The objective of this study was to evaluate endoscopic ultrasound Trucut biopsy (TCB) specimens and compare these findings to fine needle aspiration (FNA) specimens for the diagnosis of neoplasia. FNA and TCB specimens were reviewed in blinded fashion by a cytopathologist from patients (N = 93) who had EUS-guided FNA and TCB specimens collected between July 2000 and January 2005. Specimens were categorized as nondiagnostic, negative, suspicious for stromal neoplasm, suspicious for malignancy, positive for stromal neoplasm, or positive for malignancy. Standard final diagnosis based on clinical and/or pathologic follow-up was available for 86 of 93 patients. The final diagnoses comprised malignancy (n = 55), stromal neoplasm (n = 19), and benign findings (n = 12). The combination of FNA and TCB results combined were significantly (P < 0.001) more sensitive that FNA alone for the detection of both malignancy (78% vs. 55%) and stromal neoplasia (79% vs. 19%) without a significant change in overall specificity (92% vs. 100%, P = 1.00). A positive FNA specimen with a negative/nondiagnostic TCB result was established in seven patients with malignancy. A positive TCB diagnosis with a negative/nondiagnostic FNA result was noted in five patients with malignancy. A suspicious FNA result was upgraded to positive in conjunction with TCB specimen evaluation in eight patients with malignancy. The results of this study suggest that TCB is a useful adjunctive technique when used in tandem with FNA for malignancy and stromal neoplasia detection. Additional data are needed to firmly establish practice guidelines for the use of EUS-guided TCB specimens in clinical practice.

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 98%

Comparison of EUS‐guided FNA and Trucut biopsy for diagnosing and staging abdominal and mediastinal neoplasms

Kipp¹,

Pereira²,

Souza³

et al. 2009

Diagnostic Cytopathology

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“…Despite recent advances in minimally invasive imaging diagnosis [1,2], obtaining tissue samples through High accuracy rates have been reported for tissuebased assessment of suspicious lymph nodes in patients with lung, esophageal, gastric or pancreatic tumors [7][8][9]. The risk of bleeding, infection, perforation or pancreatitis when targeting pancreatic masses is cited among the most common complications, their incidence being as low as 1% [10,11].…”

Section: Introductionmentioning

confidence: 99%

Multicenter randomized controlled trial comparing the performance of 22 gauge versus 25 gauge EUS–FNA needles in solid masses

Vilmann

Săftoiu

Hollerbach

et al. 2013

Scandinavian Journal of Gastroenterology

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“…Establishment of a malignant diagnosis for a pancreatic lesion may trigger further evaluation of surrounding/adjacent tissue or organs such as subcarinal and celiac lymph node(s) or liver if indicated. 18,19 Sampling of these additional sites may be important for staging and identification of metastatic disease, which is crucial for patient management. 20 On the other hand, the findings from additional biopsy sites may help render a diagnosis for a pancreatic lesion.…”

Section: Practice Of Rosementioning

confidence: 99%

Rapid On-Site Evaluation for Endoscopic Ultrasound–Guided Fine-Needle Aspiration Diagnosis of Pancreatic Lesions

Cai

Sun

Aslanian

et al. 2015

Pathology Case Reviews

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Rapid on-site evaluation (ROSE) has repeatedly been shown to improve diagnostic performance of endoscopic ultrasound-guided fineneedle aspiration of pancreatic lesions. However, the practice of providing ROSE service varies among institutions. ROSE helps to ensure adequate sampling, appropriate specimen triage, and timely patient management. In this review, we discuss the practice and clinical significance of ROSE, the factors influencing the ROSE diagnosis, the financial considerations for providing ROSE service, and pitfalls to render a ROSE diagnosis.A 22-year-old woman was found to have a pancreatic mass during workup for acute lower abdominal pain. She was referred to our institution for further evaluation. Endoscopic ultrasound (EUS) revealed a predominantly solid mass in the head of the pancreas without involvement of adjacent vasculature. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed with rapid on-site evaluation (ROSE). The Diff-Quik-stained smears were cellular and consisted of papillary and dyscohesive clusters as well as single epithelioid cells (Fig. 1). The tumor cells were uniform and had oval nuclei (Fig. 2). Based on clinical presentation and cytomorphologic features, the ROSE diagnosis was "suspicious for solid pseudopapillary neoplasm." Additional passes were performed to collect material for cell block preparation. The Papanicolaou-stained smears showed similar cytomorphologic features. The tumor cells had evenly distributed chromatin, longitudinal nuclear grooves, and small nucleoli (Fig. 3). Immunocytochemical studies were performed on the cell block sections to substantiate the diagnosis. The tumor cells were positive for vimentin (Fig. 4), CD10, and β-catenin (Fig. 5) and negative for AE1/AE3 (Fig. 6), chromogranin, and synaptophysin. The final cytological diagnosis was "consistent with solid pseudopapillary neoplasm," which was confirmed on surgical pathology.

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Evaluation of performance of EUS‐FNA in preoperative lymph node staging of cancers of esophagus, lung, and pancreas

Cited by 21 publications

References 24 publications

Comparison of EUS‐guided FNA and Trucut biopsy for diagnosing and staging abdominal and mediastinal neoplasms

Comparison of EUS‐guided FNA and Trucut biopsy for diagnosing and staging abdominal and mediastinal neoplasms

Multicenter randomized controlled trial comparing the performance of 22 gauge versus 25 gauge EUS–FNA needles in solid masses

Rapid On-Site Evaluation for Endoscopic Ultrasound–Guided Fine-Needle Aspiration Diagnosis of Pancreatic Lesions

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