Annals of Thoracic Medicine
ORIGINAL ARTICLE
Year
: 2012  |  Volume : 7  |  Issue : 2  |  Page : 84--91

Combined use of EUS-guided FNA and immunocytochemical stains discloses metastatic and unusual diseases in the evaluation of mediastinal lymphadenopathy of unknown etiology


Mohamad A Eloubeidi1, Ali S Khan2, Leticia P Luz2, Ami Linder3, Daniel M Moreira4, David R Crowe3, Isam A Eltoum3 
1 Division of Gastroenterology and Hepatology, Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama; The American University of Beirut School of Medicine, Beirut, Lebanon
2 Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham, Birmingham, Alabama, Lebanon
3 Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, Lebanon
4 Department of Urology, Duke University Medical Center, Beirut, Lebanon

Correspondence Address:
Mohamad A Eloubeidi
Division of Gastroenterology and Hepatology, American University of Beirut School of Medicine, P.O. Box 11 0236 Riad El Solh 110 72020, Beirut
Lebanon

Purpose: Mediastinal lymphadenopathy (ML) is a cause for concern, especially in patients with previous malignancy. We report our experience with the use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with immunocytochemical stains in patients being evaluated for ML. Methods: Retrospective analysis of patients with ML of unknown origin who underwent EUS-FNA. On-site evaluation was performed by experienced cytologist, and special immunocytochemical stains were requested as indicated. Results: A total of 116 patients were included, and a total of 136 mediastinal LN were sampled. Prior malignancy was present in 45%. The most common site of examined lymph node (LN) were subcarinal (76%, 103 LN). The median long and short axis diameters were 28 mm and 13 mm, respectively. FNA was read on-site as malignant, 21 (16%); benign, 100 (76.9%); suspicious, six (4%); atypical, 3 (2%); and inadequate sample, six (4%). Sixty-four LN were deferred for additional studies; 22 for immunocytochemical and 26 for Gimesa (GMS) stain and 21 for flow cytometry. Final FNA read was malignant in 28 (21%), benign in 103 (76%), suspicious in three (2%), and atypical in two (1%). Metastatic malignancies disclosed included Hodgkin«SQ»s and Non-Hodgkin«SQ»s lymphoma, melanoma, hepatoma, breast, lung, colon, renal, endometrial, Fallopian tube, and unknown carcinoma. The sensitivity, specificity, and accuracy of the final FNA read to predict malignancy were 100%. Conclusion: EUS-guided FNA with additional ancillary studies is useful in disclosing metastatic ML from a variety of neoplasms. Due to its safety and accuracy profile, it should be considered the test of choice in evaluating abnormal ML in appropriately selected patients.


How to cite this article:
Eloubeidi MA, Khan AS, Luz LP, Linder A, Moreira DM, Crowe DR, Eltoum IA. Combined use of EUS-guided FNA and immunocytochemical stains discloses metastatic and unusual diseases in the evaluation of mediastinal lymphadenopathy of unknown etiology.Ann Thorac Med 2012;7:84-91


How to cite this URL:
Eloubeidi MA, Khan AS, Luz LP, Linder A, Moreira DM, Crowe DR, Eltoum IA. Combined use of EUS-guided FNA and immunocytochemical stains discloses metastatic and unusual diseases in the evaluation of mediastinal lymphadenopathy of unknown etiology. Ann Thorac Med [serial online] 2012 [cited 2022 May 27 ];7:84-91
Available from: https://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2012;volume=7;issue=2;spage=84;epage=91;aulast=Eloubeidi;type=0