title: EUS-guided biopsy for the diagnosis and classification of lymphoma.
abstract: BACKGROUND
  EUS-guided FNA and Tru-cut biopsy (TCB) is highly accurate in the diagnosis of lymphoma. Subclassification, however, may be difficult in low-grade non-Hodgkin lymphoma and Hodgkin lymphoma.
  
  
  OBJECTIVE
  To determine the yield of EUS-guided biopsy to classify lymphoma based on the World Health Organization classification of tumors of hematopoietic lymphoid tissues.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  A total of 24 patients referred for EUS-guided biopsy who had a final diagnosis of lymphoma or "highly suspicious for lymphoma."
  
  
  METHODS
  EUS-guided FNA and TCB combined with flow cytometry (FC) analysis. MAIN OUTCOMES MEASUREMENT: Lymphoma subclassification accuracy of EUS guided biopsy.
  
  
  RESULTS
  Twenty-four patients were included in this study. Twenty-three patients underwent EUS-FNA, and 1 patient had only TCB. Twenty-two underwent EUS-TCB combined with FNA. EUS correctly diagnosed lymphoma in 19 out of 24 patients (79%), and subclassification was determined in 16 patients (66.6%). Flow cytometry correctly identified B-cell monoclonality in 95% (18 out of 19). In 1 patient diagnosed as having marginal-zone lymphoma by EUS-FNA/FC only, the diagnosis was changed to hairy cell leukemia after a bone marrow biopsy was obtained. EUS had a lower yield in nonlarge B-cell lymphoma (only 9 out of 15 cases [60%]) compared with large B-cell lymphoma (78%; P = .3 [Fisher exact test]).
  
  
  CONCLUSIONS
  Retrospective, small number of patients.
  
  
  CONCLUSIONS
  EUS-guided biopsy has a lower yield to correctly classify Hodgkin lymphoma and low-grade lymphoma compared with high-grade diffuse large B-cell lymphoma.
authors.affiliation: Division of Gastroenterology, Miller School of Medicine, University of Miami, Miami, Florida 33101, USA. aribeiro@med.miami.edu
authors.forename: Afonso
authors.initials: A
authors.lastname: Ribeiro
authors.forename: Denise
authors.initials: D
authors.lastname: Pereira
authors.forename: Maricer P
authors.initials: MP
authors.lastname: Escalón
authors.forename: Mark
authors.initials: M
authors.lastname: Goodman
authors.forename: Gerald E
authors.initials: GE
authors.lastname: Byrne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001853:Bone Marrow / Q000473:pathology; D019160:Endosonography; D005260:Female; D005434:Flow Cytometry; D006689:Hodgkin Disease / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000000981:diagnostic imaging / Q000473:pathology; D008223:Lymphoma / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology*; D016393:Lymphoma, B-Cell / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology; D018442:Lymphoma, B-Cell, Marginal Zone / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional; D055815:Young Adult