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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2016; 07(02): 051-054
DOI: 10.4103/0976-5042.189137
Original Article
Journal of Digestive Endoscopy

Impact of endoscopic ultrasound-guided fine needle aspiration of small lymph nodes

Narendra S. Choudhary
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Rinkesh Kumar Bansal
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Rajesh Puri
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Vijay Bodh
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Gaurav Kumar Patil
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Mukesh Nasa
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Rajiv Ranjan Singh
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Haimanti Sarin
1   Department of Cytopathology, Medanta - The Medicity, Gurgaon, Haryana, India
,
Mridula Guleria
1   Department of Cytopathology, Medanta - The Medicity, Gurgaon, Haryana, India
,
Randhir Sud
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2019 (online)

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Abstract

Background: There is very limited literature on results of fine needle aspiration (FNA) of small (defined as ≤1 cm at long and short axis) lymph nodes, particularly in the setting of pyrexia of unknown origin (PUO). Methods: The study was conducted from July 2014 to December 2015 at a tertiary care center. A total of 34 endoscopic ultrasound (EUS)-guided FNAs in 33 patients were done for lymph nodes ≤1 cm at long and short axis and these were included in the analysis. Results: The study cohort comprised 33 patients; 23 males and 10 females, mean age of 58 ± 12 years. Indication of FNA was to look for malignancy (n = 15), PUO (n = 16), unexplained weight loss (n = 1), and presence of lymphadenopathy in prospective liver donor (n = 1). The FNA was taken from mediastinal nodes (n = 20, 14 subcarinal) and abdominal (n = 14, 8 at porta). The mean size of lymph nodes was 87 ± 11 mm at large axis and 68 ± 17 mm at short axis. A total of 3 (8.8%) FNAs were nondiagnostic (inadequate material). The cytopathologic diagnosis was malignancy in 8 (23.5%), granulomatous change in 8 (23.5%), and reactive lymphadenopathy in 15 (44.1%). Thus, EUS-guided FNA of these small nodes changed the management decisions in 44% of cases (one patient had tubercular lymphadenopathy at two sites). The 22-gauge EUS FNA needle was used in majority of patients (n = 26). There was no significant difference between pathologic (malignant and granulomatous) and reactive lymph nodes regarding size at long or short axis, ratio of long and short axis, hypoechogenicity, and sharply defined borders. Conclusion: EUS-guided FNA of small lymph nodes showed pathological enlargement in 44% of cases.

Key words

Axis - granulomatous - lymph node - pyrexia of unknown origin
 

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