EUS-guided fine-needle aspiration combined with flow cytometry and immunocytochemistry in the diagnosis of lymphoma☆,☆☆
Section snippets
Materials and methods
Thirty-eight consecutive patients (19 men and 19 women) with lymphadenopathy on imaging studies and/or GI mucosal lesions whose appearance suggested lymphoma underwent EUS from 1994 through 1999. The cases were divided into 2 groups according to their final diagnosis: lymphoma (23 patients) and benign diseases or reactive lymphadenopathy (15 patients). The cases originated from two different medical centers: Mayo Clinic, Rochester, Minnesota (7 patients) and St. Vincent Hospitals and Health
Results
Thirty-eight patients (19 women and 19 men) who underwent EUS-FNA were included: 23 patients with lymphoma and 15 with benign lymphadenopathy. Descriptive data for both groups are shown in Table 1.
Empty Cell Lymphoma Benign p value Site of primary lymphoma or lymphadenopathy GI Esophageal 1 Gastric 9 Pancreas 2 Duodenum 1 Non-GI Mediastinal 7 9 Intra-abdominal 2 6 Both 1 Mean age (y) 66 56 0.001 Hypoechoic LNs (%) 53 28 0.05 Mean long axis (mm) (range) 20 (5-80) 18 (7-41) 0.8 Mean number of needle passes (range) 6
Discussion
This study demonstrated that EUS-FNA combined with FC/IC can assist in the primary diagnosis of lymphoma and in differentiating benign disease from lymphoma. In patients undergoing EUS-FNA in whom cytology alone is insufficient to establish a diagnosis, flow cytometry was used to isolate and examine subpopulations of lymphocytes on the basis of their immunophenotypic characteristics. FC/IC phenotyping for immunoglobulin light chain restriction (κ/λ ratio of >3:1 or <1:2) or the presence of an
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Reprint requests: Maurits J. Wiersema, MD, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW Rochester, MN 55905.
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Gastrointest Endosc 2001;53:485-91