title: Usefulness of EUS-guided fine needle aspiration biopsy in the diagnosis of suspected or recurring lymphoproliferative disorders.
abstract: BACKGROUND
  EUS-guided fine needle aspiration biopsy (EUS-FNAB) of deep-seated lymphadenopathy is proposed to identify lymphoproliferative disorders when no superficial lesion is accessible.
  
  
  METHODS
  We analyzed prospectively collected data of 115 EUS-FNABs from 73 thoracic or abdomino-pelvic targets in 52 patients with suspected lymphoproliferative disorders (LPDs) between January 2005 and May 2011 from a single institution. Conventional histology and immunohistochemistry procedures were performed on samples.
  
  
  RESULTS
  No complications were recorded. An LPD was identified in 29 cases and ruled out in 21 cases. In 2 cases the analysis was negative, but an LPD was identified using a secondary procedure. For the identification of LPDs irrespective of subtype, this procedure has positive and negative predictive values of 100% and 91.3% respectively, with 93.6% sensitivity and 100% specificity. In 31 patients finally diagnosed with LPDs, an accurate diagnosis meeting the 2008 World Health Organization classification criteria was established in 21 (68%) cases, success being significantly associated with target size above 30 mm in multivariate analysis (odds ratio 7.47; p = 0.05).
  
  
  CONCLUSIONS
  EUS-FNAB of deep-seated lymphadenopathy with conventional morphological assessment appears to have a high diagnostic value for LPD identification and can obviate invasive surgery. A sub-classification was possible in two thirds of the cases.
authors.affiliation: Department of Digestive and Hepatobiliary Diseases, CHU Estaing de Clermont-Ferrand, F-63003 Clermont-Ferrand, France; UMR Université d'Auvergne/CNRS 6284 ISIT, Clermont-Ferrand, France. Electronic address: lpoincloux@chu-clermontferrand.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Poincloux
authors.affiliation: Department of Digestive and Hepatobiliary Diseases, CHU Estaing de Clermont-Ferrand, F-63003 Clermont-Ferrand, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: André
authors.affiliation: Department of Pathology, CHU Gabriel Montpied Clermont-Ferrand, F-63003 Clermont-Ferrand, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Darcha
authors.affiliation: Department of Digestive and Hepatobiliary Diseases, CHU Estaing de Clermont-Ferrand, F-63003 Clermont-Ferrand, France; Clinical Research Unit, CHU Estaing de Clermont-Ferrand, F-63003 Clermont-Ferrand, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Goutte
authors.affiliation: Department of Digestive and Hepatobiliary Diseases, CHU Estaing de Clermont-Ferrand, F-63003 Clermont-Ferrand, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Dapoigny
authors.affiliation: Department of Digestive and Hepatobiliary Diseases, CHU Estaing de Clermont-Ferrand, F-63003 Clermont-Ferrand, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Bommelaer
authors.affiliation: Department of Digestive and Hepatobiliary Diseases, CHU Estaing de Clermont-Ferrand, F-63003 Clermont-Ferrand, France; UMR Université d'Auvergne/CNRS 6284 ISIT, Clermont-Ferrand, France.
authors.forename: Armand
authors.initials: A
authors.lastname: Abergel
authors.affiliation: Department of Haematology and Cell Therapy, CHU Estaing de Clermont-Ferrand, Inserm CIC-501, Université d'Auvergne, CREaT - EA3846, Clermont-Ferrand, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Tournilhac
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D019160:Endosonography / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult
keywords: EUS-FNAB; Immunohistochemistry; Lymphoma; Sub-classification