Predictive factors for inaccurate diagnosis of swollen lymph nodes in endoscopic ultrasound-guided fine needle aspiration

Yuki Fujii, Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Keisuke Yonamine, Yujiro Kawakami, Toji Murabayashi, Fumisato Kozakai, Yutaka Noda, Hiroyuki Okada, Kei Ito

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background/Aims: This study aimed to identify the predictive factors for inaccurate endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnosis of swollen lymph nodes without rapid on-site cytopathological evaluation. Methods: Eighty-three consecutive patients who underwent EUS-FNA for abdominal or mediastinal lymph nodes from January 2008 to June 2017 were included from a prospectively maintained EUS-FNA database and retrospectively reviewed. The sensitivity, specificity, and accuracy of EUS-FNA for the detection of neoplastic diseases were calculated. Candidate factors for inaccurate diagnosis (lymph node size and location, needle type, puncture route, number of passes, and causative disease) were evaluated by comparison between accurately diagnosed cases and others. Results: The final diagnosis of the punctured lymph node was classified as neoplastic (65 cases: a metastatic lymph node, malignant lymphoma, or Crow-Fukase syndrome) or non-neoplastic (18 cases: a reactive node or amyloidosis). The sensitivity, specificity, and accuracy were 83%, 94%, and 86%, respectively. On multivariate analyses, small size of the lymph node was the sole predictive factor for inaccurate EUS-FNA diagnosis with a significant difference (odds ratios, 19.8; 95% confidence intervals, 3.15-124; p=0.0015). Conclusions: The lymph node size of <16 mm was the only independent factor associated with inaccurate EUS-FNA diagnosis of swollen lymph nodes.

Original languageEnglish
Pages (from-to)152-158
Number of pages7
JournalClinical Endoscopy
Volume52
Issue number2
DOIs
Publication statusPublished - 2019
Externally publishedYes

Keywords

  • Accuracy
  • Endosonography
  • Lymphadenopathy
  • Lymphoma
  • Risk factors

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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  • Cite this

    Fujii, Y., Kanno, Y., Koshita, S., Ogawa, T., Kusunose, H., Masu, K., Sakai, T., Yonamine, K., Kawakami, Y., Murabayashi, T., Kozakai, F., Noda, Y., Okada, H., & Ito, K. (2019). Predictive factors for inaccurate diagnosis of swollen lymph nodes in endoscopic ultrasound-guided fine needle aspiration. Clinical Endoscopy, 52(2), 152-158. https://doi.org/10.5946/CE.2018.125