Utility of immediate evaluation of endoscopic ultrasound-guided transesophageal fine needle aspiration of mediastinal lymph nodes.
OBJECTIVE
To assess the value of immediate cytologic evaluation (ICE) in mediastinal endoscopic ultrasound-guided transesophageal fine needle aspiration (EUS-FNA).


METHODS
Fifty eight patients with mediastinal lymphadenopathy underwent transesophageal EUS-FNA. Cellularity, number of needle passes and number of slides prepared were reviewed retrospectively.


RESULTS
Of moderate to highly cellular passes, 75% were diagnostic. ICE had a 100% positive predictive value and 97% negative predictive value. ICE allowed a diagnosis in all cases. Calculated diagnostic accuracy was 70% if the procedure ended after a single specimen of at least moderate cellularity or after completion of 4 needle passes.


CONCLUSIONS
Immediate cytologic evaluation of EUS-FNA specimens allowed a diagnosis in all cases and contributed to the utility of EUS-FNA as a diagnostic procedure for mediastinal adenopathy.
Department of Pathology and Internal Medicine, University of California San Diego, San Diego, California 92103, USA.
Shawn Clark
SC
Emery
Thomas J
TJ
Savides
Cynthia A
CA
Behling
D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods* / Q000592:standards; D002277:Carcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D003937:Diagnosis, Differential; D019160:Endosonography / Q000295:instrumentation / Q000379:methods*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies