Liu Tianye, Baskota Swikrity Upadhyay, Gonzalez Abel
Department of Pathology and Cell Biology, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York.
Department of Pathology and Laboratory Medicine, University of California-Davis Health System, Davis, California.
J Am Soc Cytopathol. 2025 Mar-Apr;14(2):102-109. doi: 10.1016/j.jasc.2024.12.002. Epub 2024 Dec 20.
The role of endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy (EUS-FNA/B) in the clinical management of gastrointestinal lymphoma has not been extensively studied. This study investigates the use of EUS-FNA/B in the diagnosis of first-time and recurrent gastrointestinal lymphomas at a large academic institution.
A total of 40 patients who had final diagnosis of lymphoma according to the World Health Organization (WHO) classification of tumors of hematopoietic lymphoid tissues who underwent EUS-FNA/B were included in the study. Cases with concurrent forceps mucosal biopsies or lost to clinical follow-up were excluded. The diagnostic accuracy and clinical use of EUS-FNA/B was investigated by comparing EUS-FNA/B diagnosis with the final diagnosis.
EUS-FNA/B diagnoses were concordant with the final WHO diagnosis for as high as 72.5% of the cases. Of the remaining 27.5%, 17.5% had enough cytologic features for lymphoma diagnosis with incomplete phenotyping, while the remaining 10.0% showed features suspicious for lymphoma. Cell block and flow cytometry quality significantly affected diagnostic accuracy. Number of passes between 1 and 5 yielded better diagnostic accuracy than 6 or more passes during FNA; however, no difference was identified during procedures that used FNB alone or combined with FNA. There is no significant difference in onsite adequacy diagnostic performance of EUS-FNA performed by cytopathologists or cytotechnologists.
EUS-FNA/B with concurrent ancillary studies such as immunocytochemistry in cell block and flow cytometry can be helpful in efficient first and recurrent diagnoses of gastrointestinal lymphomas.
内镜超声引导下细针穿刺抽吸和细针活检（EUS-FNA/B）在胃肠道淋巴瘤临床管理中的作用尚未得到广泛研究。本研究调查了在一家大型学术机构中EUS-FNA/B在初发和复发性胃肠道淋巴瘤诊断中的应用。
本研究纳入了40例根据世界卫生组织（WHO）造血淋巴组织肿瘤分类最终诊断为淋巴瘤且接受了EUS-FNA/B的患者。排除同时进行钳取黏膜活检或失访的病例。通过将EUS-FNA/B诊断结果与最终诊断结果进行比较，研究EUS-FNA/B的诊断准确性和临床应用情况。
EUS-FNA/B诊断结果与WHO最终诊断结果高达72.5%的病例一致。在其余27.5%的病例中，17.5%具有足够的细胞学特征可诊断为淋巴瘤，但表型分析不完整，而其余10.0%表现出可疑的淋巴瘤特征。细胞块和流式细胞术质量显著影响诊断准确性。FNA过程中穿刺1至5次的诊断准确性优于穿刺6次或更多次；然而，在单独使用FNB或与FNA联合使用的操作中未发现差异。细胞病理学家或细胞技术人员进行的EUS-FNA现场充分性诊断性能无显著差异。
EUS-FNA/B结合细胞块免疫细胞化学和流式细胞术等辅助研究，有助于高效地进行胃肠道淋巴瘤的初发和复发诊断。
