AUTHOR=Wang Wenli , Han Chaoqun , Ling Xin , Guo Xianwen , Liu Jun , Lin Rong , Ding Zhen 

TITLE=Diagnostic role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in abdominal lymphadenopathy of unknown etiology

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1221085

DOI=10.3389/fmed.2023.1221085

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Background</title><p>Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an established method for the evaluation of abdominal organ lesions. However, there are few studies on EUS-FNA for abdominal lymph node (LN) lesions. The purpose of this study was to evaluate the diagnostic role of EUS-FNA in isolated abdominal lymphadenopathy (LAP).</p></sec><sec id="sec2"><title>Methods</title><p>A retrospective analysis was performed on patients with isolated abdominal LAP who underwent a EUS-FNA examination. The diagnosis was made based on cytology, histology, and immunohistochemical (IHC) studies. The area under curve (AUC) value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated.</p></sec><sec id="sec3"><title>Results</title><p>A total of 99 patients were included in this study. The final diagnoses were metastatic tumor (<italic>n</italic> = 32), lymphoma (<italic>n</italic> = 32), tuberculosis (<italic>n</italic> = 17), sarcoidosis (<italic>n</italic> = 5), castleman’s disease (<italic>n</italic> = 1), and reactive LAP (<italic>n</italic> = 12). The AUC value, sensitivity, specificity, PPV, NPV, and accuracy of EUS-FNA in the diagnosis of malignant LAP were 0.9531, 90.6, 100, 100, 85.4, and 93.9%, respectively. For the diagnosis of lymphoma, the accuracy of EUS-FNA combined with IHC staining was 94.9%. Retroperitoneal LN enlargement is more commonly associated with lymphoma, while hepatic hilar LN enlargement predominantly suggests benign conditions or metastatic tumors. Malignant lymph nodes are more likely to be regular border, circular/quasi-circular, and fusion. Lymphomas are more likely to present with fusion and heterogeneous echogenicity than metastatic tumors.</p></sec><sec id="sec4"><title>Conclusion</title><p>EUS-FNA is a safe and effective method to diagnose isolated abdominal LAP.</p></sec>