TRANSGASTRIC ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION BIOPSY FOR LYMPHOMA DIAGNOSIS OF ISOLATED SPLENIC LESIONS.
(Abstract release date: 05/19/16)
EHA Library. Cuccaro A. 06/09/16; 134603; PB1703
Dr. Annarosa Cuccaro
Contributions
Contributions
Abstract
Abstract: PB1703
Type: Publication Only
Background
Isolated splenic lesions are relatively infrequent, but represent a diagnostic challenge, as tissue sampling for histologic analysis may be difficult, in particular if the size of the lesion is small. Percutaneous image-guided splenic biopsies are rarely performed due to the perceived high risk of hemorrhage that could lead to urgent splenectomy, and diagnostic splenectomy is often preferred as primary diagnostic procedure. Endoscopic ultrasonography (EUS)-guided fine needle aspiration (EUS-FNA) biopsy allows sampling of tissue which is adjacent to the stomach wall. EUS provides a good imaging of the spleen through the gastric wall. There have been only few cases of successful histopathologic diagnoses by EUS-guided splenic biopsies reported in the literature. We report our experience with trans-gastric EUS-FNA in the investigation of patients with isolated splenic lesions suspicious for lymphoma.
Aims
We retrospectively assessed the diagnostic performance and safety of EUS-FNA to elucidate the tissue diagnosis of splenic abnormalities suspicious for lymphoma.
Methods
Between 2009 and 2016, we evaluated nine patients with splenic lesions detected by CT, Positron Emission Tomography (PET) and US in our Institution. We used a linear echo-endoscope and 19/20 gauge needles for transgastric EUS-FNA biopsy. Patients were admitted to the hospital to guarantee an overnight monitoring after the procedure. Platelet counts were in the normal range and INR was < 1.5.
Results
The age of the patients was 40–83 year (average 58.6 year); five patients were male and four female. All patients presented focal splenic lesions that varied in size from 17 to 100 mm (average 41 mm). Bone marrow biopsy was negative for lymphoma localization, and lymph node involvement was absent or minimal. There was no evidence of bleeding or other complications related to the procedure after splenic EUS-FNA biopsy. In seven patients tissue sampling was sufficient for a pathological diagnosis (78% sensitivity). Diagnoses were Hodgkin Lymphoma in two patients, and Diffuse Large B-cell Lymphoma (DLBCL) in five patients. Only two patients required further diagnostic procedures, including laparoscopic spleen biopsy in one patient and splenectomy in one patient. In both cases final diagnosis was DLBCL.
Conclusion
Transgastric EUS-FNA biopsy of splenic lesions is a safe diagnostic procedure with high sensitivity for the diagnosis of lymphoma, reducing the need for splenectomy.
Session topic: E-poster
Keyword(s): Diagnosis, Lymphoproliferative disorder, Spleen
Type: Publication Only
Background
Isolated splenic lesions are relatively infrequent, but represent a diagnostic challenge, as tissue sampling for histologic analysis may be difficult, in particular if the size of the lesion is small. Percutaneous image-guided splenic biopsies are rarely performed due to the perceived high risk of hemorrhage that could lead to urgent splenectomy, and diagnostic splenectomy is often preferred as primary diagnostic procedure. Endoscopic ultrasonography (EUS)-guided fine needle aspiration (EUS-FNA) biopsy allows sampling of tissue which is adjacent to the stomach wall. EUS provides a good imaging of the spleen through the gastric wall. There have been only few cases of successful histopathologic diagnoses by EUS-guided splenic biopsies reported in the literature. We report our experience with trans-gastric EUS-FNA in the investigation of patients with isolated splenic lesions suspicious for lymphoma.
Aims
We retrospectively assessed the diagnostic performance and safety of EUS-FNA to elucidate the tissue diagnosis of splenic abnormalities suspicious for lymphoma.
Methods
Between 2009 and 2016, we evaluated nine patients with splenic lesions detected by CT, Positron Emission Tomography (PET) and US in our Institution. We used a linear echo-endoscope and 19/20 gauge needles for transgastric EUS-FNA biopsy. Patients were admitted to the hospital to guarantee an overnight monitoring after the procedure. Platelet counts were in the normal range and INR was < 1.5.
Results
The age of the patients was 40–83 year (average 58.6 year); five patients were male and four female. All patients presented focal splenic lesions that varied in size from 17 to 100 mm (average 41 mm). Bone marrow biopsy was negative for lymphoma localization, and lymph node involvement was absent or minimal. There was no evidence of bleeding or other complications related to the procedure after splenic EUS-FNA biopsy. In seven patients tissue sampling was sufficient for a pathological diagnosis (78% sensitivity). Diagnoses were Hodgkin Lymphoma in two patients, and Diffuse Large B-cell Lymphoma (DLBCL) in five patients. Only two patients required further diagnostic procedures, including laparoscopic spleen biopsy in one patient and splenectomy in one patient. In both cases final diagnosis was DLBCL.
Conclusion
Transgastric EUS-FNA biopsy of splenic lesions is a safe diagnostic procedure with high sensitivity for the diagnosis of lymphoma, reducing the need for splenectomy.
Session topic: E-poster
Keyword(s): Diagnosis, Lymphoproliferative disorder, Spleen
Abstract: PB1703
Type: Publication Only
Background
Isolated splenic lesions are relatively infrequent, but represent a diagnostic challenge, as tissue sampling for histologic analysis may be difficult, in particular if the size of the lesion is small. Percutaneous image-guided splenic biopsies are rarely performed due to the perceived high risk of hemorrhage that could lead to urgent splenectomy, and diagnostic splenectomy is often preferred as primary diagnostic procedure. Endoscopic ultrasonography (EUS)-guided fine needle aspiration (EUS-FNA) biopsy allows sampling of tissue which is adjacent to the stomach wall. EUS provides a good imaging of the spleen through the gastric wall. There have been only few cases of successful histopathologic diagnoses by EUS-guided splenic biopsies reported in the literature. We report our experience with trans-gastric EUS-FNA in the investigation of patients with isolated splenic lesions suspicious for lymphoma.
Aims
We retrospectively assessed the diagnostic performance and safety of EUS-FNA to elucidate the tissue diagnosis of splenic abnormalities suspicious for lymphoma.
Methods
Between 2009 and 2016, we evaluated nine patients with splenic lesions detected by CT, Positron Emission Tomography (PET) and US in our Institution. We used a linear echo-endoscope and 19/20 gauge needles for transgastric EUS-FNA biopsy. Patients were admitted to the hospital to guarantee an overnight monitoring after the procedure. Platelet counts were in the normal range and INR was < 1.5.
Results
The age of the patients was 40–83 year (average 58.6 year); five patients were male and four female. All patients presented focal splenic lesions that varied in size from 17 to 100 mm (average 41 mm). Bone marrow biopsy was negative for lymphoma localization, and lymph node involvement was absent or minimal. There was no evidence of bleeding or other complications related to the procedure after splenic EUS-FNA biopsy. In seven patients tissue sampling was sufficient for a pathological diagnosis (78% sensitivity). Diagnoses were Hodgkin Lymphoma in two patients, and Diffuse Large B-cell Lymphoma (DLBCL) in five patients. Only two patients required further diagnostic procedures, including laparoscopic spleen biopsy in one patient and splenectomy in one patient. In both cases final diagnosis was DLBCL.
Conclusion
Transgastric EUS-FNA biopsy of splenic lesions is a safe diagnostic procedure with high sensitivity for the diagnosis of lymphoma, reducing the need for splenectomy.
Session topic: E-poster
Keyword(s): Diagnosis, Lymphoproliferative disorder, Spleen
Type: Publication Only
Background
Isolated splenic lesions are relatively infrequent, but represent a diagnostic challenge, as tissue sampling for histologic analysis may be difficult, in particular if the size of the lesion is small. Percutaneous image-guided splenic biopsies are rarely performed due to the perceived high risk of hemorrhage that could lead to urgent splenectomy, and diagnostic splenectomy is often preferred as primary diagnostic procedure. Endoscopic ultrasonography (EUS)-guided fine needle aspiration (EUS-FNA) biopsy allows sampling of tissue which is adjacent to the stomach wall. EUS provides a good imaging of the spleen through the gastric wall. There have been only few cases of successful histopathologic diagnoses by EUS-guided splenic biopsies reported in the literature. We report our experience with trans-gastric EUS-FNA in the investigation of patients with isolated splenic lesions suspicious for lymphoma.
Aims
We retrospectively assessed the diagnostic performance and safety of EUS-FNA to elucidate the tissue diagnosis of splenic abnormalities suspicious for lymphoma.
Methods
Between 2009 and 2016, we evaluated nine patients with splenic lesions detected by CT, Positron Emission Tomography (PET) and US in our Institution. We used a linear echo-endoscope and 19/20 gauge needles for transgastric EUS-FNA biopsy. Patients were admitted to the hospital to guarantee an overnight monitoring after the procedure. Platelet counts were in the normal range and INR was < 1.5.
Results
The age of the patients was 40–83 year (average 58.6 year); five patients were male and four female. All patients presented focal splenic lesions that varied in size from 17 to 100 mm (average 41 mm). Bone marrow biopsy was negative for lymphoma localization, and lymph node involvement was absent or minimal. There was no evidence of bleeding or other complications related to the procedure after splenic EUS-FNA biopsy. In seven patients tissue sampling was sufficient for a pathological diagnosis (78% sensitivity). Diagnoses were Hodgkin Lymphoma in two patients, and Diffuse Large B-cell Lymphoma (DLBCL) in five patients. Only two patients required further diagnostic procedures, including laparoscopic spleen biopsy in one patient and splenectomy in one patient. In both cases final diagnosis was DLBCL.
Conclusion
Transgastric EUS-FNA biopsy of splenic lesions is a safe diagnostic procedure with high sensitivity for the diagnosis of lymphoma, reducing the need for splenectomy.
Session topic: E-poster
Keyword(s): Diagnosis, Lymphoproliferative disorder, Spleen
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