Pancreatobiliary Lymphadenopathy: Etiology, Location, and Factors Predicting Good Yield of Endoscopic Ultrasound-guided Biopsy.

Abbas Ali Tasneem, Taha Yaseen, Syed Mudassir Laeeq, Zain Majid, Nasir Hassan Luck
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引用次数: 0

Abstract

Introduction: Pancreatobiliary lymphadenopathy (PBL) may be due to a number of benign or malignant causes. Tissue sampling of these lymph nodes (LN) can be possible with the help of endoscopic ultrasound (EUS). Aim of this study was to identify the etiology of the PBL, morphology, and factors predicting good yield of biopsy with EUS.

Materials and methods: All patients found to have pancreatobiliary lymph node (PBLN) enlargement (>10 mm) on abdominal imaging and referred for EUS-guided biopsy were included in this prospective observational study. The facility of rapid on-site evaluation (ROSE) was not available. Adequacy of the tissue specimen was assessed by the endoscopist with macroscopic on-site evaluation (MOSE) and then sent to histopathologist for final diagnosis. Factors predicting good yield of biopsy were then analyzed.

Results: Of the total 87 patients with PBL, 54 (62.1%) were males. Mean age of the patients was 52.0 (±13.4) and range 18-80 years. The commonest locations of PBL were porta hepatis 37 (42.5%), peripancreatic 24 (27.6%), celiac 16 (18.4%), and others 10 (11.5%). Histological reports showed: neoplastic tissue in 34 (39.1%), non-neoplastic in 20 (23%), normal lymphoid tissue (27.6%) and suboptimal in 9 (10.3%). Among the 34 neoplastic causes, 26 had metastatic adenocarcinoma, 5 had lymphoma, and 3 had metastatic neuroendocrine tumors. Among the 20 non-neoplastic causes, 10 had tuberculosis, 4 had anthracosis, and 6 had other findings. Factors predicting good yield of biopsy were a PBLN size ≥12 mm and satisfactory MOSE on both univariate [PBLN (p = 0.005); MOSE (p < 0.0001)] and multivariate [PBLN (p = 0.011); MOSE (p < 0.0001)] analysis.

Conclusion: The commonest etiology of PBLN enlargement was metastatic adenocarcinoma among the neoplastic causes and tuberculosis among the non-neoplastic causes. The most common PBLNs approached by EUS were in portahepatis and peripancreatic regions. A good biopsy yield can be predicted with PBLN size of ≥12 mm and a satisfactory MOSE.

How to cite this article: Tasneem AA, Yaseen T, Laeeq SM, et al. Pancreatobiliary Lymphadenopathy: Etiology, Location, and Factors Predicting Good Yield of Endoscopic Ultrasound-guided Biopsy. Euroasian J Hepato-Gastroenterol 2024;14(1):40-43.

胰胆管淋巴腺病:病因、位置和内窥镜超声引导活检良率的预测因素。
导言:胰胆管淋巴结病(PBL)可能由多种良性或恶性病因引起。在内镜超声(EUS)的帮助下,可以对这些淋巴结(LN)进行组织取样。本研究的目的是确定胰腺淋巴结的病因、形态以及预测 EUS 活检良率的因素:这项前瞻性观察研究纳入了所有在腹部影像学检查中发现胰胆管淋巴结(PBLN)肿大(>10 毫米)并在 EUS 引导下进行活检的患者。不提供快速现场评估(ROSE)设施。组织标本的充分性由内镜医师通过宏观现场评估(MOSE)进行评估,然后送至组织病理学家进行最终诊断。然后对预测活检良率的因素进行了分析:在总共 87 例 PBL 患者中,54 例(62.1%)为男性。患者的平均年龄为 52.0 (±13.4)岁,年龄范围为 18-80 岁。PBL 最常见的部位是肝门 37 例(42.5%)、胰周 24 例(27.6%)、腹腔 16 例(18.4%)和其他 10 例(11.5%)。组织学报告显示:34 例(39.1%)为肿瘤组织,20 例(23%)为非肿瘤组织,27.6% 为正常淋巴组织,9 例(10.3%)为亚健康组织。在 34 例肿瘤性病例中,26 例为转移性腺癌,5 例为淋巴瘤,3 例为转移性神经内分泌肿瘤。在 20 个非肿瘤性病因中,10 个是结核病,4 个是炭疽病,6 个是其他病因。在单变量[PBLN(P = 0.005);MOSE(P < 0.0001)]和多变量[PBLN(P = 0.011);MOSE(P < 0.0001)]分析中,预测活检良率的因素是PBLN大小≥12毫米和满意的MOSE:结论:PBLN增大最常见的病因是肿瘤性病因中的转移性腺癌和非肿瘤性病因中的结核病。经 EUS 检出的最常见 PBLN 位于门肝区和胰周。如果PBLN大小≥12毫米且MOSE令人满意,则可预测良好的活检率:Tasneem AA, Yaseen T, Laeeq SM, et al.胰胆管淋巴腺病:病因、位置和内镜超声引导活检良率预测因素。Euroasian J Hepato-Gastroenterol 2024;14(1):40-43.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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