title: Diagnosis of deep-seated lymphomas by endoscopic ultrasound-guided fine needle aspiration combined with flow cytometry.
abstract: OBJECTIVE
  Although endoscopic ultrasound combined with fine needle aspiration (EUS-FNA) is rapidly becoming the preferred diagnostic approach for the sampling and diagnosis of gastrointestinal and mediastinal malignancies, there are limited data as to its use in the diagnosis of lymphoproliferative disorders. Therefore, we carried out a retrospective evaluation of the performance of EUS-guided FNA combined with flow cytometry (FC) as a tool to improve overall sensitivity and specificity in the diagnosis of lymphoma.
  
  
  METHODS
  Of 1560 patients having EUS-guided FNA during the period of the study, a total of 56 patients were evaluated by cytology with FC after EUS-FNA. There was adequate material to perform FC analysis for all but one case.
  
  
  RESULTS
  EUS-FNA-FC gave a diagnosis of lymphoma in 11 cases and of reactive lymphadenopathy in 20. A specific histological type was defined by FC alone in eight cases. The remaining cases were diagnosed later by cytology and cell block sections: 13 carcinomas, nine granulomatous lymphadenopathies and one mediastinal extramedullary haematopoiesis. One case was considered only suspicious for lymphoma on cytology and FC but was not confirmed on molecular analysis and one had insufficient material for FC.
  
  
  CONCLUSIONS
  Our results show that a combination of EUS-FNA-FC is a feasible and highly accurate method, which may be used for the diagnosis and subtyping of deep-seated lymphoma, providing a significant improvement to cytomorphology alone both for diagnosis and treatment planning, as long as immunocytochemistry is available for non-lymphoma cases.
authors.affiliation: Flow Cytometry Unit, Department of Pathology, Molinette Hospital, Turin, Italy. astacchini@molinette.piemonte.it
authors.forename: A
authors.initials: A
authors.lastname: Stacchini
authors.forename: P
authors.initials: P
authors.lastname: Carucci
authors.forename: D
authors.initials: D
authors.lastname: Pacchioni
authors.forename: G
authors.initials: G
authors.lastname: Accinelli
authors.forename: A
authors.initials: A
authors.lastname: Demurtas
authors.forename: S
authors.initials: S
authors.lastname: Aliberti
authors.forename: M
authors.initials: M
authors.lastname: Bosco
authors.forename: M
authors.initials: M
authors.lastname: Bruno
authors.forename: A
authors.initials: A
authors.lastname: Balbo Mussetto
authors.forename: M
authors.initials: M
authors.lastname: Rizzetto
authors.forename: G
authors.initials: G
authors.lastname: Bussolati
authors.forename: C
authors.initials: C
authors.lastname: De Angelis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology; D019160:Endosonography / Q000379:methods*; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006410:Hematopoiesis; D006801:Humans; D007150:Immunohistochemistry; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity