EUS-guided biopsy for the diagnosis and classification of lymphoma

Afonso Ribeiro, Denise L Pereira, Maricer P. Escalón, Mark Goodman, Gerald E. Byrne

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: EUS-guided FNA and Tru-cut biopsy (TCB) is highly accurate in the diagnosis of lymphoma. Subclassification, however, may be difficult in low-grade non-Hodgkin lymphoma and Hodgkin lymphoma. Objective: To determine the yield of EUS-guided biopsy to classify lymphoma based on the World Health Organization classification of tumors of hematopoietic lymphoid tissues. Design: Retrospective study. Setting: Tertiary referral center. Patients: A total of 24 patients referred for EUS-guided biopsy who had a final diagnosis of lymphoma or "highly suspicious for lymphoma.". Interventions: EUS-guided FNA and TCB combined with flow cytometry (FC) analysis. Main Outcomes Measurement: Lymphoma subclassification accuracy of EUS guided biopsy. Results: Twenty-four patients were included in this study. Twenty-three patients underwent EUS-FNA, and 1 patient had only TCB. Twenty-two underwent EUS-TCB combined with FNA. EUS correctly diagnosed lymphoma in 19 out of 24 patients (79%), and subclassification was determined in 16 patients (66.6%). Flow cytometry correctly identified B-cell monoclonality in 95% (18 out of 19). In 1 patient diagnosed as having marginal-zone lymphoma by EUS-FNA/FC only, the diagnosis was changed to hairy cell leukemia after a bone marrow biopsy was obtained. EUS had a lower yield in nonlarge B-cell lymphoma (only 9 out of 15 cases [60%]) compared with large B-cell lymphoma (78%; P = .3 [Fisher exact test]). Limitations: Retrospective, small number of patients. Conclusion: EUS-guided biopsy has a lower yield to correctly classify Hodgkin lymphoma and low-grade lymphoma compared with high-grade diffuse large B-cell lymphoma.

Original languageEnglish
Pages (from-to)851-855
Number of pages5
JournalGastrointestinal Endoscopy
Volume71
Issue number4
DOIs
StatePublished - Apr 1 2010

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Lymphoma
Biopsy
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Non-Hodgkin's Lymphoma
Flow Cytometry
B-Cell Lymphoma
Hodgkin Disease
Hairy Cell Leukemia
Lymphoma, Large B-Cell, Diffuse
Lymphoid Tissue
Tertiary Care Centers
B-Lymphocytes
Retrospective Studies
Bone Marrow
Neoplasms

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

EUS-guided biopsy for the diagnosis and classification of lymphoma. / Ribeiro, Afonso; Pereira, Denise L; Escalón, Maricer P.; Goodman, Mark; Byrne, Gerald E.

In: Gastrointestinal Endoscopy, Vol. 71, No. 4, 01.04.2010, p. 851-855.

Research output: Contribution to journalArticle

Ribeiro, Afonso ; Pereira, Denise L ; Escalón, Maricer P. ; Goodman, Mark ; Byrne, Gerald E. / EUS-guided biopsy for the diagnosis and classification of lymphoma. In: Gastrointestinal Endoscopy. 2010 ; Vol. 71, No. 4. pp. 851-855.
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N2 - Background: EUS-guided FNA and Tru-cut biopsy (TCB) is highly accurate in the diagnosis of lymphoma. Subclassification, however, may be difficult in low-grade non-Hodgkin lymphoma and Hodgkin lymphoma. Objective: To determine the yield of EUS-guided biopsy to classify lymphoma based on the World Health Organization classification of tumors of hematopoietic lymphoid tissues. Design: Retrospective study. Setting: Tertiary referral center. Patients: A total of 24 patients referred for EUS-guided biopsy who had a final diagnosis of lymphoma or "highly suspicious for lymphoma.". Interventions: EUS-guided FNA and TCB combined with flow cytometry (FC) analysis. Main Outcomes Measurement: Lymphoma subclassification accuracy of EUS guided biopsy. Results: Twenty-four patients were included in this study. Twenty-three patients underwent EUS-FNA, and 1 patient had only TCB. Twenty-two underwent EUS-TCB combined with FNA. EUS correctly diagnosed lymphoma in 19 out of 24 patients (79%), and subclassification was determined in 16 patients (66.6%). Flow cytometry correctly identified B-cell monoclonality in 95% (18 out of 19). In 1 patient diagnosed as having marginal-zone lymphoma by EUS-FNA/FC only, the diagnosis was changed to hairy cell leukemia after a bone marrow biopsy was obtained. EUS had a lower yield in nonlarge B-cell lymphoma (only 9 out of 15 cases [60%]) compared with large B-cell lymphoma (78%; P = .3 [Fisher exact test]). Limitations: Retrospective, small number of patients. Conclusion: EUS-guided biopsy has a lower yield to correctly classify Hodgkin lymphoma and low-grade lymphoma compared with high-grade diffuse large B-cell lymphoma.

AB - Background: EUS-guided FNA and Tru-cut biopsy (TCB) is highly accurate in the diagnosis of lymphoma. Subclassification, however, may be difficult in low-grade non-Hodgkin lymphoma and Hodgkin lymphoma. Objective: To determine the yield of EUS-guided biopsy to classify lymphoma based on the World Health Organization classification of tumors of hematopoietic lymphoid tissues. Design: Retrospective study. Setting: Tertiary referral center. Patients: A total of 24 patients referred for EUS-guided biopsy who had a final diagnosis of lymphoma or "highly suspicious for lymphoma.". Interventions: EUS-guided FNA and TCB combined with flow cytometry (FC) analysis. Main Outcomes Measurement: Lymphoma subclassification accuracy of EUS guided biopsy. Results: Twenty-four patients were included in this study. Twenty-three patients underwent EUS-FNA, and 1 patient had only TCB. Twenty-two underwent EUS-TCB combined with FNA. EUS correctly diagnosed lymphoma in 19 out of 24 patients (79%), and subclassification was determined in 16 patients (66.6%). Flow cytometry correctly identified B-cell monoclonality in 95% (18 out of 19). In 1 patient diagnosed as having marginal-zone lymphoma by EUS-FNA/FC only, the diagnosis was changed to hairy cell leukemia after a bone marrow biopsy was obtained. EUS had a lower yield in nonlarge B-cell lymphoma (only 9 out of 15 cases [60%]) compared with large B-cell lymphoma (78%; P = .3 [Fisher exact test]). Limitations: Retrospective, small number of patients. Conclusion: EUS-guided biopsy has a lower yield to correctly classify Hodgkin lymphoma and low-grade lymphoma compared with high-grade diffuse large B-cell lymphoma.

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