Benias Petros C, D'Souza Lionel S, Papafragkakis Haris, Kim Joseph, Harshan Manju, Theise Neil D, Carr-Locke David L
Division of Digestive Diseases, Mount Sinai Beth Israel Medical Center, New York, New York, USA.
Division of Gastroenterology, The Brooklyn Hospital Center, Brooklyn, New York, USA.
Endoscopy. 2016 Oct;48(10):923-8. doi: 10.1055/s-0042-109775. Epub 2016 Jul 19.
Current modalities for lymph node staging in cancer can be limited. We sought to evaluate the feasibility of needle-based confocal laser endomicroscopy (nCLE) at the time of endoscopic ultrasound (EUS) and to describe the nCLE features that distinguish between benign, malignant, and inflammatory lymph nodes.
We collected data on 28 consecutive patients during EUS staging of malignancy or assessment of enlarged lymph nodes. Patients underwent nCLE at the time of EUS followed by fine needle biopsy. nCLE images were correlated with the patients' final histopathology.
All 28 patients successfully underwent nCLE during EUS without adverse events. There were 17 cases of carcinoma, 4 lymphoid malignancies, and 7 benign lymph nodes. We characterized the various nCLE features of the lymph node capsule and cortex. Features of carcinoma, such as clusters of dark pleomorphic tumor cells, were identified and found to correlate well with the final pathology. Lymphoid malignancies often had enlarged follicles, but this was inconsistent.
nCLE of lymph nodes at the time of EUS is feasible and appears to be safe. Dark pleomorphic cells were readily identified in all of the malignant lymph nodes and correlated with tumor cells seen on histology.
目前癌症淋巴结分期的方法可能存在局限性。我们旨在评估内镜超声（EUS）检查时基于针的共聚焦激光内镜显微镜检查（nCLE）的可行性，并描述区分良性、恶性和炎性淋巴结的nCLE特征。
我们收集了28例连续患者在进行恶性肿瘤EUS分期或评估肿大淋巴结时的数据。患者在EUS检查时接受nCLE检查，随后进行细针穿刺活检。nCLE图像与患者的最终组织病理学结果相关联。
所有28例患者在EUS检查时均成功接受了nCLE检查，无不良事件发生。其中有17例癌、4例淋巴恶性肿瘤和7例良性淋巴结。我们对淋巴结包膜和皮质的各种nCLE特征进行了描述。发现了癌的特征，如深色多形性肿瘤细胞簇，且与最终病理结果相关性良好。淋巴恶性肿瘤通常有增大的滤泡，但并不一致。
EUS检查时对淋巴结进行nCLE检查是可行的，且似乎是安全的。在所有恶性淋巴结中均能轻易识别出深色多形性细胞，且与组织学上所见的肿瘤细胞相关。
