Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Comparison of 19-gauge conventional and Franseen needles for the diagnosis of lymphadenopathy and classification of malignant lymphoma using endoscopic ultrasound fine-needle aspiration

  • Mitsuru Okuno (Department of Gastroenterology, Gifu Municipal Hospital) ;
  • Keisuke Iwata (Department of Gastroenterology, Gifu Municipal Hospital) ;
  • Tsuyoshi Mukai (Department of Gastroenterology, Gifu Municipal Hospital) ;
  • Yusuke Kito (Department of Pathology and Translational Research, Gifu University Graduate School of Medicine) ;
  • Takuji Tanaka (Department of Diagnostic Pathology, Gifu Univeristy Hospital) ;
  • Naoki Watanabe (Department of Diagnostic Pathology, Gifu Univeristy Hospital) ;
  • Senji Kasahara (Department of Hematology, Gifu Univeristy Hospital) ;
  • Yuhei Iwasa (Department of Gastroenterology, Gifu Municipal Hospital) ;
  • Akihiko Sugiyama (Department of Gastroenterology, Gifu Municipal Hospital) ;
  • Youichi Nishigaki (Department of Gastroenterology, Gifu Municipal Hospital) ;
  • Yuhei Shibata (Department of Hematology, Gifu Univeristy Hospital) ;
  • Junichi Kitagawa (Department of Hematology, Gifu Univeristy Hospital) ;
  • Takuji Iwashita (Department of First Department of Internal Medicine, Gifu Univeristy Hospital) ;
  • Eiichi Tomita (Department of Gastroenterology, Gifu Municipal Hospital) ;
  • Masahito Shimizu (Department of First Department of Internal Medicine, Gifu Univeristy Hospital)
  • Received : 2023.03.25
  • Accepted : 2023.05.11
  • Published : 2024.05.30
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Abstract

Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) using a 19-gauge needle is an efficient sampling method for the diagnosis of lymphadenopathy. This study compared 19-gauge conventional and Franseen needles for the diagnosis of lymphadenopathy and classification of malignant lymphoma (ML). Methods: Patient characteristics, number of needle passes, puncture route, sensitivity, specificity, and accuracy of cytology/histology for lymphadenopathy were analyzed in patients diagnosed with lymphadenopathy by EUS-FNA using conventional or Franseen needles. Results: Between 2012 and 2022, 146 patients met the inclusion criteria (conventional [n=70] and Franseen [n=76]). The median number of needle passes was significantly lower in the conventional group than in the Franseen group (3 [1-6] vs. 4 [1-6], p=0.023). There were no significant differences in cytological/ histological diagnoses between the two groups. For ML, the immunohistochemical evaluation rate, sensitivity of flow cytometry, and cytogenetic assessment were not significantly different in either group. Bleeding as adverse events (AEs) were observed in three patients in the Franseen group. Conclusions: Both the 19-gauge conventional and Franseen needles showed high accuracy in lymphadenopathy and ML classification. Considering sufficient tissue collection and the avoidance of AEs, the use of 19-gauge conventional needles seems to be a good option for the diagnosis of lymphadenopathy.

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References

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