title: Hodgkin's disease diagnosed by endoscopic ultrasound-guided fine needle aspiration of a periduodenal lymph node.
abstract: Hodgkin's disease rarely presents as obstructive jaundice. We report a case of Hodgkin's disease arising in periduodenallymph nodes, presenting with biliary obstruction, definitively diagnosed on cytologic material obtained by endosonographically-guided real-time fine needle aspiration biopsy and confirmed at laparotomy. The medical literature pertaining to the use of endosonography and fine needle aspiration biopsy for pancreatic lesions and abdominal lymphoma is reviewed. Currently available data support the use of fine needle aspiration biopsy in establishing the diagnosis of lymphoma. This case highlights the utility of endoscopic ultrasonography with endosonographically guided real-time fine needle aspiration biopsy in diagnosing and managing patients with extrahepatic biliary obstruction or suspected abdominal lymphoma. Pairing endosonographically guided real-time fine needle aspiration biopsy with on-site cytologic assessment and immediate specimen triage can lead to definitive diagnosis of abdominal lymphoma, avoiding surgical intervention in many cases.
authors.affiliation: Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Lewis
authors.forename: D O
authors.initials: DO
authors.lastname: Faigel
authors.forename: Y
authors.initials: Y
authors.lastname: Dowdy
authors.forename: M J
authors.initials: MJ
authors.lastname: Sack
authors.forename: K E
authors.initials: KE
authors.lastname: Salhany
authors.forename: B
authors.initials: B
authors.lastname: Haynes
authors.forename: K R
authors.initials: KR
authors.lastname: Fox
authors.forename: G G
authors.initials: GG
authors.lastname: Ginsberg
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D001651:Cholestasis, Extrahepatic / Q000209:etiology; D004386:Duodenum; D019160:Endosonography; D006689:Hodgkin Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D018084:Ultrasonography, Interventional