title: Use of ancillary techniques in improving the yield of samples obtained at endoscopic ultrasound-guided fine needle aspiration of thoracic and abdominal lymph nodes.
abstract: OBJECTIVE
  Thoracic and abdominal lymph nodes may be enlarged in a variety of disorders. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a well-established technique for sampling such nodes, but samples obtained are small, which may make definitive diagnosis difficult. We conducted a retrospective review to determine the contribution of ancillary techniques, such as special histochemistry (SHC), immunohistochemistry (IHC) and flow cytometry, in increasing the diagnostic yield of EUS-FNA carried out at our institution.
  
  
  METHODS
  Between November 2005 and December 2012, 278 patients underwent EUS-FNA of enlarged thoracic and abdominal nodes at our institution. All specimens obtained were subjected to rapid on-site evaluation. Data were reviewed in all patients requiring ancillary techniques for definitive diagnosis.
  
  
  RESULTS
  Ancillary techniques were performed in 111 of 278 cases. IHC was performed in 24, flow cytometry in 3 and SHC staining in 84. IHC and SHC aided in reaching a definitive diagnosis in 19 of 24 and 3 cases, respectively. Flow cytometry led to a definitive diagnosis in 3 cases. A total of 80 cases were also submitted to culture for tuberculosis with 6 positive for Mycobacterium tuberculosis.
  
  
  CONCLUSIONS
  Ancillary studies in EUS-FNA of thoracic and abdominal lymph nodes can significantly improve the yield of EUS-FNA.
authors: Department of Pathology and Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
authors: Asif
authors: A
authors: Loya
authors: Mohammad
authors: M
authors: Nadeem
authors: Muhammed Aasim
authors: MA
authors: Yusuf
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D019160:Endosonography / Q000379:methods; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013909:Thorax / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult