经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

经支气管针吸活检术联合超声内镜引导下经食管细针穿刺活检术在纵隔肺门病变中的诊断价值

目的 探讨经支气管针吸活检术(TBNA)联合超声内镜引导下经食管细针穿刺活检术(EUS-FNA)在纵隔、肺门病变的定性诊断及肺癌N分期中的应用价值.方法 对129例影像学检查提示存在纵隔、肺门病变的患者行TBNA或EUS-FNA,穿刺标本均行病理和细胞学检查.结果 联合应用TBNA和EUS-FNA的诊断率为89.9%(116/129),其中行TBNA 59例,诊断率为84.7%(50/59);行EUS-FNA 70例,诊断率为94.3%(66/70).细胞学和病理学诊断率分别为92.2%(107/116)和87.9%(102/116).通过病理检查,可使诊断率提高8.4%(9/107).116例通过穿刺诊断的患者中,有103例患者得到明确组织分型,细胞学和病理组织分型诊断率分别为73.8%(76/103)和89.3%(92/103).通过病理检查,可使组织分型诊断率提高35.5%(27/76).结论 联合应用TBNA和EUS-FNA能扩大穿刺技术对纵隔肺门病变的诊断范围,提高诊断水平.病理检查可提高TBNA和EUS-FNA的诊断率和组织分型的诊断率.     

Improvement of cellularity on cell block preparations using the so-called tissue coagulum clot method during endobronchial ultrasound-guided transbronchial fine-needle aspiration

BACKGROUND:

Cell block (CB) preparation during the endobronchial ultrasound‐guided transbronchial fine‐needle aspiration (EBUS‐TBNA) procedure plays an important role in the diagnosis of lung cancer and recovery of cellular material for molecular characterization of the tumor. However, the efficiency of the conventional method of CB preparation is suboptimal.

METHODS:

In the current study, the “tissue coagulum clot” cell block (TCC‐CB) method was used to prepare the CBs and its efficiency was compared with that of the conventional saline rinse cell block (NR‐CB) method. A total of 84 consecutive TCC‐CBs (106 lymph nodes [LNs] and 14 lung lesions) and 28 consecutive cases of NR‐CB (39 LNs and 3 lung lesions) obtained within the same time period were included in the current study.

RESULTS:

In the TCC‐CB specimens, 94 of 106 LN cases (88.7%) yielded sufficient diagnostic material, as did 11 of 14 lung lesions (78.6%). In the NR‐CB group, which was used as the control, 22 of 39 LN specimens (56.4%) and none of 3 lung specimens (0%) were found to provide sufficient diagnostic material. Although the average size of the LNs in the study group were not significantly different from those in the control group (1.76 cm vs 1.82 cm; P > .05), the overall nondiagnostic rates in the TCC‐CB and NR‐CB groups were 11.2% and 43.6%, respectively (P < .001). The nondiagnostic rates of the lung specimens were 15.4% in the TCC‐CB group and 100% in the NR‐CB group (P < .05). In addition, immunohistochemistry studies and epidermal growth factor receptor (EGFR)/KRAS mutational analyses were performed in 26 and 14 TCC‐CB cases, respectively. With the exception of 1 case, all of them had satisfactory results.

CONCLUSIONS:

The data from the current study demonstrate that the TCC‐CB method significantly increases the cellular yield of CB preparations without compromising cytomorphological characterization of tumor cells. Cancer (Cancer Cytopathol) 2012;. © 2011 American Cancer Society.     

Telecytopathology for immediate evaluation of fine‐needle aspiration specimens

BACKGROUND:

On‐site evaluation of fine‐needle aspiration (FNA) specimens by a pathologist is essential to obtain adequate samples and provide a preliminary diagnosis. Distance from the laboratory can make this difficult. The authors present their experience with on‐site evaluation using telecytopathology.

METHODS:

Dynamic images of cytology smears were captured and processed with a Nikon digital camera system for microscopy and transmitted via Ethernet. A pathologist accessed the real‐time images on a computer and interpreted them while communicating with on‐site operators over the telephone. Sample adequacy and accuracy of preliminary diagnosis were compared with those obtained by regular on‐site evaluation.

RESULTS:

A total of 429 telecytopathology cases and 363 conventional on‐site cases were compared. Specimens were mainly from the pancreas, gastrointestinal tract, liver, and lymph nodes. Adequacy rate was 94.0% for telecytopathology and 97.7% for conventional cases. Preliminary diagnoses of unsatisfactory, adequate (defer), negative/benign, atypical, neoplasm, suspicious, and positive for malignancy were 6.3%, 13.5%, 14.9%, 17.9%, 7.2%, 8.6%, and 31.5% for telecytopathology and 3.9%, 30.6%, 21.5%, 9.6%, 5.0%, 5.2%, and 24.2% for conventional cases. Preliminary and final diagnoses were discrepant in 7 (1.8%) of 371 telecytopathology cases, and in 8 (3.1%) of 252 conventional cases. Difficulty was encountered in some cases in distinguishing pancreatic endocrine neoplasm from lymphoid proliferations, and low grade pancreatic tumors from chronic pancreatitis via telecytopathology.

CONCLUSIONS:

On‐site evaluation of FNA specimens via telecytopathology assures sample adequacy and accurate preliminary diagnosis compared with the conventional method. It allows pathologists to use their time more efficiently and makes on‐site evaluations at remote locations possible. Cancer (Cancer Cytopathol) 2010. © 2010 American Cancer Society.     

Extramedullary plasmacytoma of the gallbladder diagnosed by endoscopic ultrasound fine needle aspiration (EUS-FNA)

Extramedullary plasmacytoma (EMP) is a rare entity that can exist independently or in conjunction with underlying plasma cell myeloma (PCM). When there is underlying multiple myeloma, the presence of EMP portends a poor prognosis. The most common locations for an EMP include the gastrointestinal tract, pleura, testis, skin, peritoneum, liver, endocrine glands and lymph nodes; involvement of the gallbladder is exceedingly rare with only five other cases reported and only one of which was associated with PCM. EMP of the gallbladder can manifest as acute cholecystitis, biliary obstruction, or may be asymptomatic. Treatment is traditionally surgical resection plus adjuvant chemotherapy or autologous stem cell transplant. We present a case of a 53-year-old man with PCM who was found to have a gallbladder mass on imaging and underwent endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) of the mass, which was diagnostic of a plasma cell neoplasm.     

The utility of endobronchial ultrasound-guided transbronchial needle aspiration biopsy in the diagnosis of mediastinal lymphoproliferative disorders

BACKGROUND:

Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) biopsy is routinely used to stage lung cancer; however, its usefulness in diagnosing lymphoproliferative disorders has not been well established. In this retrospective study, we determined the utility of EBUS‐TBNA in evaluating mediastinal lymphadenopathy in patients with suspected lymphoproliferative disorders.

METHODS:

The authors searched the pathology database at their institution to identify all patients who had undergone EBUS‐TBNA biopsy for possible lymphoproliferative disorders. The cytologic diagnoses were correlated with concurrent and subsequent biopsy findings and clinical follow‐up data.

RESULTS:

Of 886 lymph nodes evaluated by EBUS‐TBNA biopsy, 91 nodes from 33 patients (23 men and 10 women) were eligible. Fourteen patients had a history of lymphoma. Adequate material for diagnosis was obtained in 31 of 34 procedures (1 patient had 2 procedures). The cytologic diagnoses of the 31 adequate procedures included 19 with benign disease (8 reactive lymph nodes and 11 granulomatous inflammation), 8 with lymphoma (2 large B‐cell, 2 small lymphocytic, 2 Hodgkin, 1 mantle cell, and 1 T‐cell lymphoblastic), 2 with cells suspicious for Hodgkin lymphoma, and 2 cases with atypical cells.

CONCLUSIONS:

EBUS‐TBNA proved to be useful for evaluating mediastinal lymphadenopathy in patients with suspected lymphoproliferative disorders. Its use may decrease the need for invasive diagnostic procedures. Immediate assessment is valuable in these cases because of the need to triage material for immunophenotyping or other studies to determine optimal and clinically meaningful diagnoses. Cancer (Cancer Cytopathol) 2011. © 2011 American Cancer Society