Endoscopy 2011; 43 - A23
DOI: 10.1055/s-0031-1292094

Diagnosis of deep-seated lymphomas by endoscopic ultrasound guided fine needle aspiration combined with flow cytometric analysis

C De Angelis 1, A Stacchini 2, P Carucci 1, D Pacchioni 3, M Goss 1, G Accinelli 3, A Demurtas 2, S Aliberti 2, M Bruno 1, F Brizzi 1, P Allegranza 1, D Reggio 4, M Rizzetto 1
  • 1Department of Gastrohepatology, University of Turin, Italy
  • 2Flow cytometry unit, Department of Pathology, Molinette Hospital, Turin, Italy
  • 3Department of Biomedical Sciences and Human Oncology, University of Turin, Italy
  • 4OLT Surgery, “S. Giovanni Battista – Molinette” Hospital, University of Turin, Italy

Objective: Endoscopic ultrasound combined with fine needle aspiration (EUS-FNA) is rapidly becoming the preferred diagnostic approach for the sampling and diagnosis of gastrointestinal and mediastinal malignancies; limited data however exist regarding its use in the diagnosis of lymphoproliferative disorders. We retrospectively evaluated the performance of EUS guided FNA combined with flow cytometry (FC) as a tool to improve overall sensitivity and specificity in the diagnosis of lymphoma.

Methods: 56 patients subjected to EUS-FNA were evaluated by cytology plus FC. Adequate material to perform FC analysis was obtained for all but one case.

Results: 11 patients with lymphoma and 20 patients with reactive lymphadenopathy were identified; all these cases could be identified by FC, a specific histotype could be defined by FC alone in 8 cases. The remaining cases were diagnosed by cytology as carcinoma (13 cases), granulomatous lymphadenopathy (9 cases) and mediastinal extramedullary hematopoiesis (1 case). One case was considered only suspicious for lymphoma, one was inadequate for cytologic evaluation. The sensitivity, specificity and accuracy values of EUS-FNA-FC combination for the diagnosis of lymphoma were 100%, 96% and 97%, respectively.

Conclusions: To our knowledge the data presented here represent to date the widest series of FC applied to EUS-FNA. The combination of EUS-FNA with FC is a feasible and highly accurate method for the diagnosis and subtyping of deep-seated lymphoma and can significantly improve the performance of the cytomorphological approach both for diagnostic evaluation and treatment planning.