Hodgkin's disease diagnosed by endoscopic ultrasound-guided fine needle aspiration of a periduodenal lymph node

This review, based on the Hennepin County Medical Center experience and review of the literature, vastly covers the up-to-date role of endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (FNA) in evaluating tumorous lesions of the gastrointestinal tract and adjacent organs. Emphasis is given to the tumoral and nodal staging of esophageal, pulmonary, and pancreatic cancer. This review also discusses technical, pathological, and gastroenterologic aspects and the role of the pathologist and endosonographer in the evaluation of these lesions, as well as the corresponding FNA cytology and differential diagnosis.

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“…Hodgkin's disease rarely presents as obstructive jaundice and EUS-FNA can lead to definitive diagnosis, avoiding surgical intervention. 272…”

Section: Primary Biliary Tract Malignancymentioning

confidence: 99%

Review of endoscopic ultrasound‐guided fine‐needle aspiration cytology

Bardales

Stelow

Mallery

et al. 2006

Diagnostic Cytopathology

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“…A number of studies have demonstrated that other diagnoses from mediastinal lesions can be obtained by EUS‐FNA. Most of these studies are a mixture of patients from retrospective studies 8,18 , 19,25 , 26,31 . The diagnoses obtained are TB, lymphoma, sarcoidosis, histoplasmosis, metastases from other primary tumors such as renal cancer, breast cancer, gynecologic cancer, esophageal cancer, gastric cancer and pancreatic cancer.…”

Section: Eus‐fna In Non‐lung Cancer Diseasementioning

confidence: 99%

“…EUS‐FNA can be used either to obtain a diagnosis from an unknown primary lesion in the mediastinum or to sample tissue from mediastinal lymph nodes in order to stage lung cancer or to differential diagnose other diseases involving lymph nodes of the mediastinum. EUS‐FNA is therefore relevant for evaluation of a variety of different mediastinal lesions 5–32 …”

Section: Introductionmentioning

confidence: 99%

Eus Guided Fna for Mediastinal Tumors (Lung Cancer and Lymph Nodes)

Vilmann¹,

Larsen²,

Krasnik

2004

Digestive Endoscopy

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Trans-esophageal endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA) has proven to be a safe and minimally invasive tissue-sampling method which can be used to obtain a cytological diagnosis from mediastinal lesions. The aims of EUS-FNA in the mediastinum are either to diagnose a lesion of unknown origin, to stage mediastinal lymph nodes in lung cancer patients or to diagnose other diseases involving lymph nodes of the mediastinum. In patients with non-small cell lung cancer (NSCLC), surgery may be regarded as futile in up to 45% of patients operated, apparently because the stage of the disease is more advanced than expected preoperatively. This, combined with a stage-dependent multimodality treatment, underlines the importance of exact staging of the disease. Conventional imaging and tissue sampling methods all have variable sensitivities.Twenty-two studies concerning EUS-FNA and mediastinal staging of lung cancer have been published with a total number of 1245 patients. The reported sensitivity for mediastinal malignancy range from 0.61-1.00 (median 0.90), and with specificities of 0.71-1.00 (median 1.00). The majority of the studies are retrospective and present the results of EUS-FNA performed in lung cancer patients selected by computer tomography (CT). Recent data suggests that EUS-FNA in addition can diagnose advanced mediastinal disease in 22-42% of NSCLC patients with normal sized lymph nodes ( < 1 cm) on chest CT. EUS-FNA may also be used as a re-staging procedure after induction chemotherapy and it seems that EUS-FNA is more accurate for mediastinal staging of NSCLC compared to positron emission tomography (PET). However, further studies are necessary before final conclusions can be made. At present, mediastinoscopy is still considered complementary to EUS-FNA because EUS-FNA cannot visualize structures anterior to the air-filled trachea and main bronchi. Endoscopic trans -bronchial real-time ultrasound guided biopsy (EBUS-TBNA) performed via the trachea and main bronchi seems to be an obvious solution. Preliminary experience with a prototype EBUS-TBNA bronchoscope (Olympus, XBF-UC40P, Tokyo, Japan) in 214 patients has shown promising results. Hopefully the combination of EUS-FNA and EBUS-TBNA will be able to replace more invasive and risky staging methods and improve the N-staging accuracy of the mediastinum and lung hilar regions in the near future.Key words: endoscopic ultrasound guided biopsy from lymph nodes in the mediastinum, endosonography guided biopsy of the mediastinum, EUS-FNA, lung cancer staging, staging of NSCLC.

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Jaundice caused by a clinically undetectable T-cell lymphoma infiltrating the sphincter of Oddi

Weinstock

Swanson

Bennett

et al. 2001

Am J Gastroenterology

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Malignant lymphoma rarely presents with jaundice. We describe a patient who had a unique etiology for painless jaundice, dilated ducts, and a normal ampulla of Vater. A Whipple's procedure was performed for the suspicion of pancreatic cancer, and initial pathological review detected only mild focal chronic pancreatitis. Seven months later, the patient developed ascites, retroperitoneal mass, and splenomegaly caused by a T-cell lymphoma. Reevaluation of the Whipple's specimen revealed previously unrecognized microscopic infiltration and fibrosis of the sphincter of Oddi by atypical T-lymphocytes. Obstructive jaundice caused by a clinically undetectable primary duodenal T-cell lymphoma has not been previously reported and is contrasted with other causes of jaundice associated with malignant lymphoma and ampullary lesions.

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Hodgkin's disease diagnosed by endoscopic ultrasound-guided fine needle aspiration of a periduodenal lymph node

Cited by 3 publications

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Review of endoscopic ultrasound‐guided fine‐needle aspiration cytology

Review of endoscopic ultrasound‐guided fine‐needle aspiration cytology

Eus Guided Fna for Mediastinal Tumors (Lung Cancer and Lymph Nodes)

Jaundice caused by a clinically undetectable T-cell lymphoma infiltrating the sphincter of Oddi

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