title: Endoscopic ultrasound-guided fine needle aspiration biopsy for diagnosis of lymphoproliferative disorders: feasibility of immunohistological, flow cytometric, and cytogenetic assessments.
abstract: OBJECTIVE
  In addition to morphology, immunophenotype and genetic abnormalities should be assessed during diagnosis and subclassification of lymphoproliferative disorders. The objective of this study was to evaluate the yield of endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) using a standard 19-gauge needle for diagnosis and subclassification of lymphoma, assessing the feasibility of immunohistological, flow cytometric, and cytogenetic assessments.
  
  
  METHODS
  Two hundred forty patients with suspected lymphoma were referred for EUS-FNAB to our quaternary EUS center between June 2005 and December 2010. EUS-FNAB using a conventional 19-gauge needle was attempted for all patients, followed by histological assessments including immunohistological staining, flow cytometry, and cytogenetic analysis (G-band karyotyping). Among the patients, 152 were ultimately diagnosed with lymphoma. The primary outcome measure of this study was the sensitivity of histological assessment, including immunohistological staining, flow cytometry, and G-band karyotyping, for diagnosis and subclassification of lymphoma.
  
  
  RESULTS
  Among the 152 patients ultimately diagnosed with lymphoma, 147 patients (96.7%) were diagnosed by EUS-FNAB, and classification in accordance with the WHO (World Health Organization) system was also possible for 135 patients (88.8%) on the basis of histological findings, including immunohistological staining. Flow cytometry showed abnormal or unusual cell populations in 121 (79.6%) of the 152 patients diagnosed with lymphoma, and in 114 (90.5%) of the 126 patients diagnosed with B-cell lymphoma. Specific cytogenetic abnormalities were detected in 21 (13.8%) of the lymphoma patients.
  
  
  CONCLUSIONS
  EUS-FNAB using a standard 19-gauge needle has high diagnostic value for lymphoma. Immunophenotyping is usually possible, while cytogenetic abnormalities can be identified in a relatively limited number of patients.
authors: First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan. yasudaic@aol.com
authors: Ichiro
authors: I
authors: Yasuda
authors: Naoe
authors: N
authors: Goto
authors: Hisashi
authors: H
authors: Tsurumi
authors: Masanori
authors: M
authors: Nakashima
authors: Shinpei
authors: S
authors: Doi
authors: Takuji
authors: T
authors: Iwashita
authors: Nobuhiro
authors: N
authors: Kanemura
authors: Senji
authors: S
authors: Kasahara
authors: Seiji
authors: S
authors: Adachi
authors: Takeshi
authors: T
authors: Hara
authors: Masahito
authors: M
authors: Shimizu
authors: Tsuyoshi
authors: T
authors: Takami
authors: Hisataka
authors: H
authors: Moriwaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D003582:Cytogenetics; D003937:Diagnosis, Differential; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D008223:Lymphoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional