title: EUS-guided FNA combined with flow cytometry in the diagnoses of suspected or recurrent intrathoracic or retroperitoneal lymphoma.
abstract: BACKGROUND
  Limited data exist on the combined use of EUS-guided FNA (EUS-FNA) and flow cytometry (FC) in the diagnosis of lymphoma. The aim of this study was to evaluate the accuracy of EUS-FNA combined with FC in the diagnosis of primary or recurrent lymphoma.
  
  
  METHODS
  This study was a retrospective analysis of a prospective collection of data over a 3-year period. Over 3 years, 29 patients with lesions (n=31) suspicious for lymphoma underwent EUS-FNA and FC.
  
  
  RESULTS
  Of the 29 patients, 10 patients had lymphoma and 17 patients had nonlymphoma lesions; for two patients, final diagnosis was indeterminate because of insufficient material for FC. The lymphoma cases included non-Hodgkin's lymphoma (n=6, including 3 recurrences), mucosa-associated lymphoid tissue (MALT) lymphoma (n=2), a non-GI lymphoma with mediastinal lymphadenopathy (n=1), and an uncharacterized lymphoma (n=1). Of the 31 lesions, 8 were true positive, 18 were true negative, and 3 were false negative; for two lesions, we could not determine the final diagnosis. No false-positive results were encountered. The sensitivity, the specificity, and the accuracy of EUS-FNA combined with FC for diagnosing lymphoma were 72.7%: 95% CI [43.3%, 90.3%], 100%: 95% CI [82.4%, 100.0%], and 89.7%: 95% CI [73.6%, 96.4%], respectively. Limitations to this study include a short duration of follow-up and a lack of a surgical criterion standard.
  
  
  CONCLUSIONS
  EUS-FNA in combination with FC allows the diagnosis of primary suspected or recurrent lymphoma. It also is an adjunct in staging MALT lymphoma and could direct clinicians toward further investigative procedures.
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Mohit
authors.initials: M
authors.lastname: Mehra
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tamhane
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Eloubeidi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology*; D015203:Reproducibility of Results; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*