TY - JOUR
T1 - Predictive value of intra-abdominal lymph nodes in pancreatic endoscopic ultrasonography-guided fine-needle aspiration biopsy
AU - Collins, Brian T.
AU - Bernadt, Cory T.
AU - Adhikari, Laura J.
AU - Wang, Jeff F.
PY - 2014/7
Y1 - 2014/7
N2 - Introduction: Endoscopic ultrasonography (EUS)-guided fine-needle aspiration (FNA) biopsy is a commonly used method for the evaluation of pancreatic lesions. EUS-guided FNA of the intra-abdominal lymph nodes (LNs) can provide critical diagnostic information that is important for clinical management and tumor staging. This study examines the predictive value of intra-abdominal LN EUS-guided FNA biopsy associated with pancreatic lesions. Materials and methods: Over a 10-year period, the pathology database was searched for patients with concurrent pancreas and intra-abdominal LN EUS-guided FNA biopsy. The corresponding reports were reviewed, and clinical information and diagnostic results were recorded. Results: There were 252 cases where both a pancreas lesion and intra-abdominal LN were biopsied. Of this group, 182 LNs were classified as negative (72%), 47 as positive (19%), and 23 as atypical (9%). Within the negative LN cohort, the pancreas FNAs fell into the following diagnostic categories: benign (47%), malignant (30%), and atypical/suspicious (23%). Within the positive LN cohort, the pancreas lesion correlated with the following diagnostic categories: malignant (89%), atypical (4%), and suspicious (6%). A positive LN EUS-guided FNA biopsy had a 98% positive predictive value for malignancy. Within the atypical LN cohort, the pancreas correlated with the following diagnostic categories: malignant (57%), atypical/suspicious (26%), and benign (17%). Conclusions: An atypical LN diagnostic category is strongly associated with a malignant pancreas lesion. Apositive LN EUS-guided FNA biopsy has a 98% positive predictive value for pancreatic malignancy. Apositive diagnostic category for an intra-abdominal LN can provide strong predictive evidence of a corresponding malignancy of the pancreas.
AB - Introduction: Endoscopic ultrasonography (EUS)-guided fine-needle aspiration (FNA) biopsy is a commonly used method for the evaluation of pancreatic lesions. EUS-guided FNA of the intra-abdominal lymph nodes (LNs) can provide critical diagnostic information that is important for clinical management and tumor staging. This study examines the predictive value of intra-abdominal LN EUS-guided FNA biopsy associated with pancreatic lesions. Materials and methods: Over a 10-year period, the pathology database was searched for patients with concurrent pancreas and intra-abdominal LN EUS-guided FNA biopsy. The corresponding reports were reviewed, and clinical information and diagnostic results were recorded. Results: There were 252 cases where both a pancreas lesion and intra-abdominal LN were biopsied. Of this group, 182 LNs were classified as negative (72%), 47 as positive (19%), and 23 as atypical (9%). Within the negative LN cohort, the pancreas FNAs fell into the following diagnostic categories: benign (47%), malignant (30%), and atypical/suspicious (23%). Within the positive LN cohort, the pancreas lesion correlated with the following diagnostic categories: malignant (89%), atypical (4%), and suspicious (6%). A positive LN EUS-guided FNA biopsy had a 98% positive predictive value for malignancy. Within the atypical LN cohort, the pancreas correlated with the following diagnostic categories: malignant (57%), atypical/suspicious (26%), and benign (17%). Conclusions: An atypical LN diagnostic category is strongly associated with a malignant pancreas lesion. Apositive LN EUS-guided FNA biopsy has a 98% positive predictive value for pancreatic malignancy. Apositive diagnostic category for an intra-abdominal LN can provide strong predictive evidence of a corresponding malignancy of the pancreas.
KW - Adenocarcinoma
KW - Endoscopic ultrasonography
KW - Fine-needle aspiration
KW - Lymph node
KW - Pancreas
UR - http://www.scopus.com/inward/record.url?scp=84903461627&partnerID=8YFLogxK
U2 - 10.1016/j.jasc.2014.03.011
DO - 10.1016/j.jasc.2014.03.011
M3 - Article
C2 - 31051687
AN - SCOPUS:84903461627
SN - 2213-2945
VL - 3
SP - 206
EP - 210
JO - Journal of the American Society of Cytopathology
JF - Journal of the American Society of Cytopathology
IS - 4
ER -