EUS-guided fine needle aspiration (EUS-FNA) has widely accepted as a reliable diagnostic procedure in many countries. In this article, we report a case of B-cell type malignant lymphoma with huge abdominal mass and diffuse venous thrombus, diagnosed by EUS-FNA. 48 year old male complained epigastralgia, and noted a huge abdominal mass and diffuse venous thrombus by CT scan. The patient was referred to our department for evaluation. EUS revealed heterogenisity-echoic abdominal mass, and EUS-FNA was performed with 22 gauge needle. Cytology results showed B-cell type malignant lymphoma, and Flow Cytometry showed the feature of CD10+, CD19+, CD20+, κ-ch+, λ-ch-. Gene analysis showed evidence of gene point mutation at 3 genes. Pathological results strongly suggested diffuse large B cell type lymphoma (DLBCL) . Therefore, the patient had underwent Cyclo-BEAP-R regimens, and the patient had compete response (CR) and the venous thrombosis was also good controlled with anticoagrant therapy.
EUS-FNA allows abdominal or retroperitoneal evaluation pathologically without surgery. Since we started EUS-FNA in 2009, because of the high accuracy of the pathological results, the number of surgery for pathological evaluation is decreasing. Especially, EUS-FNA allows not only cytology but also Flow Cytometry, gene transmutation nor pathological results by immune stain, which is indispensable for correct diagnosis and further treatment for malignant lymphoma.
