BACKGROUND: The diagnosis of lymphadenopathy after treatment of malignancy is sometimes difficult, especially in patients whose treatment was deemed curative and without local recurrence or those who have increased serum levels of related tumor markers. We aimed to evaluate the effectiveness of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as a diagnostic tool in patients with lymphadenopathy after curative treatment of malignancy. METHODS: Consecutive patients with mediastinal, intraabdominal, or pelvic lymphadenopathy after curative treatment of malignancy who were referred to our hospital between October 2003 and September 2007 were enrolled in this study. RESULTS: A total of 62 patients were included. The lymph nodes were located at the mediastinum in 22 patients, intraabdomen in 38 patients, and intrapelvis in 2 patients. From the pathological findings of the FNA sample, 31 patients (50%) were confirmed to have recurrence of the prior malignancy, and 9 patients (15%) were diagnosed as having a different new malignancy. The remaining 22 patients (35%) were shown to have no recurrence or no other malignancies. However, 1 of them was later diagnosed with recurrence by open laparotomy. The overall sensitivity, specificity, accuracy, and positive and negative predictive values of the EUS-FNA were 97%, 100%, 98%, 100%, and 97%, respectively. CONCLUSIONS: Lymphadenopathy after treatment of malignancy is not a definitive sign of recurrence. Therefore, pathological sampling and diagnosis are essential for determining the appropriate treatment. For this purpose, EUS-FNA is a safe, convenient, and minimally invasive procedure with high diagnostic value.
BACKGROUND: The diagnosis of lymphadenopathy after treatment of malignancy is sometimes difficult, especially in patients whose treatment was deemed curative and without local recurrence or those who have increased serum levels of related tumor markers. We aimed to evaluate the effectiveness of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as a diagnostic tool in patients with lymphadenopathy after curative treatment of malignancy. METHODS: Consecutive patients with mediastinal, intraabdominal, or pelvic lymphadenopathy after curative treatment of malignancy who were referred to our hospital between October 2003 and September 2007 were enrolled in this study. RESULTS: A total of 62 patients were included. The lymph nodes were located at the mediastinum in 22 patients, intraabdomen in 38 patients, and intrapelvis in 2 patients. From the pathological findings of the FNA sample, 31 patients (50%) were confirmed to have recurrence of the prior malignancy, and 9 patients (15%) were diagnosed as having a different new malignancy. The remaining 22 patients (35%) were shown to have no recurrence or no other malignancies. However, 1 of them was later diagnosed with recurrence by open laparotomy. The overall sensitivity, specificity, accuracy, and positive and negative predictive values of the EUS-FNA were 97%, 100%, 98%, 100%, and 97%, respectively. CONCLUSIONS:Lymphadenopathy after treatment of malignancy is not a definitive sign of recurrence. Therefore, pathological sampling and diagnosis are essential for determining the appropriate treatment. For this purpose, EUS-FNA is a safe, convenient, and minimally invasive procedure with high diagnostic value.
Authors: Janak N Shah; Douglas Fraker; DuPont Guerry; Michael Feldman; Michael L Kochman Journal: Gastrointest Endosc Date: 2004-06 Impact factor: 9.427
Authors: Marc F Catalano; Rajeev Nayar; Frank Gress; James Scheiman; Wahid Wassef; M L Rosenblatt; Michael Kochman Journal: Gastrointest Endosc Date: 2002-06 Impact factor: 9.427
Authors: S M Wildi; W E Fickling; T A Day; C D Cunningham; N Schmulewitz; S Varadarajulu; S S Roberts; B Ferguson; B J Hoffman; R H Hawes; M B Wallace Journal: Endoscopy Date: 2004-07 Impact factor: 10.093
Authors: M Al-Haddad; M B Wallace; T A Woodward; S A Gross; C M Hodgens; R D Toton; M Raimondo Journal: Endoscopy Date: 2007-12-04 Impact factor: 10.093
Authors: Jinkyeong Park; Se Jin Jang; Young Soo Park; Yeon-Mok Oh; Tae Sun Shim; Woo Sung Kim; Chang Min Choi Journal: J Korean Med Sci Date: 2011-01-24 Impact factor: 2.153