ENDOSCOPIC ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION FOR THE DIAGNOSIS OF MALIGNANT LYMPHOMA

Abstract

Background : Although there have been reports of the usefulness of endoscopic ultrasound-guided fine-needle aspiration (EUS-guided FNA) for malignant lymphoma, its utility for the diagnosis of the subclassification of malignant lymphoma has not been confirmed.
Objective : Evaluating the utility of EUS-guided FNA for the diagnosis of the subclassification of malignant lymphoma.
Methods : We retrospectively examined data on 50 patients with malignant lymphoma who underwent EUS-guided FNA between February 2008 and May 2012 at our hospital. First, we evaluated the concordance rate for diagnosis of the subclassification by EUS-guided FNA and other diagnostic options such as surgery, endoscopy or percutaneous biopsy. Secondly, we investigated the diagnostic accuracy of methods of analysis of the sample specimens obtained with EUS-guided FNA which were Southern blotting, multiparameter flow cytometry (MFCM), G-band karyotyping, and fluorescence in situ hybridization (FISH).
Results : In 27 patients both EUS-guided FNA and another method of examination were performed. In all 27 patients, EUS-guided FNA diagnosis corresponded with the diagnosis by other methods of examination. The diagnostic accuracy of MFCM was 87.2%, Southern blotting was 87.0%, G-band karyotyping was 57.6% and FISH was 85.3%. The subclassification type was diagnosed in all 50 cases : diffuse large B-cell lymphoma, 22 ; follicular lymphoma, 25 ; Burkitt lymphoma, 1 : and peripheral T-cell lymphoma, 2. No serious complications occurred with the procedure.
Conclusion : With EUS-guided FNA we could safely and successfully diagnose the subclassification of malignant lymphoma. Our results suggest that EUS-guided FNA may be a useful and less invasive replacement for surgical or percutaneous biopsy in the diagnosis of subclassification of malignant lymphoma.