Cases of Malignant Lymphoma which EUS-FNA was Useful for Diagnosis

Background and Aims: The diagnosis of intra-abdominal lymphadenopathy is sometimes difficult, especially in patients who have no other accessible primary lesions. Malignant lymphoma is one of the main causes of this condition. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a safe and accurate diagnostic procedure for lesions surrounding the gastrointestinal tract. We report patients of malignant lymphoma diagnosed by EUS-FNA in our hospital.

Patients and Methods: Patients with intra-abdominal lymphadenopathy to whom EUS-FNA was performed between March 2008 and May 2010 and were diagnosed malignant lymphoma were reviewed retrospectively. Pathological diagnosis were made on the basis of cytological, histological and immunopathological staining.

Results: Five consecutive patients were reviewed. The mean age was 72.8 years. 2 patients were male, and 3 were female. The locations of the lymphadenopathy were intra-abdomen in 4 of 5 patients, adrenals in 1 of 5. EUS-FNA was carried out using a 19-gauge needle in 1 of 5 patients and 22-gauge in 4 of 5, passing through the gastric wall in all cases. EUS-FNA was performed two times in one session for 3 of 5 patients, three times, for 2 of 5 patients. Adequate specimens enough for cytological, histological and immunopathological staining were obtained in all cases. No complications occurred during the procedures. 3 patients received chemotherapy (R-CHOP). 1 patient received immunotherapy. 1 patient died before starting treatment.

Conclusions: Owing to EUS-FNA, open surgery, laparotomy, and other invasive diagnostic procedures could be avoided. EUS-FNA is clinically very useful for establishing the diagnosis of intra-abdominal malignant lymphoma without any other accessible primary lesions.