Role of endoscopic ultrasound guided fine needle aspiration/biopsy in the evaluation of intra-abdominal lymphadenopathy due to tuberculosis  

作　　者：Harshavardhan Rao B Priya Nair S Krishna Priya Archana George Vallonthaiel Dipu T Sathyapalan Anoop K Koshy Rama P Venu 

机构地区：[1]Department of Gastroenterology,Amrita Institute of Medical Sciences,Kochi 682041,Kerala,India [2]Department of Pathology,Amrita Institute of Medical Sciences,Kochi 682041,Kerala,India [3]Department of Internal Medicine,Amrita Institute of Medical Sciences and Research Centre,Kochi 682041,Kerala,India

出　　处：《World Journal of Gastrointestinal Endoscopy》2021年第12期649-658,共10页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Intra-abdominal lymphadenopathy due to tuberculosis(TB)poses a diagnostic challenge due to difficulty in tissue acquisition.Although endoscopic ultrasound guided fine needle aspiration/biopsy(EUS-FNA/B)has shown promise in the evaluation of mediastinal lymph nodes,its role in the evaluation of intra-abdominal lymphadenopathy is not clear.AIM To assess the role of EUS-FNA/B in the evaluation of intra-abdominal lymphadenopathy due to TB.METHODS This was a retrospective study where patients with intra-abdominal lymphadenopathy who underwent evaluation with EUS-FNA/B were included.TB was diagnosed if the patient had any one of the following:(1)Positive acid fast bacilli(AFB)stain/TB GeneXpert/TB-polymerase chain reaction/AFB culture of tissue sample;and(2)Positive Mantoux test and response to anti-tubercular therapy.EUS-FNA reports,clinical reports and imaging characteristics of patients were recorded for a detailed analysis of patients with TB.RESULTS A total of 149 patients underwent an EUS-FNA/B from lymph nodes(mean age 51±17 years,M:F=1.2).Benign inflammatory reactive changes were seen in 45 patients(30.2%),while 54 patients(36.2%)showed granulomatous inflammation with/without caseation.Among these,51 patients(94.4%)were confirmed to have TB as per pre-defined criteria.Patients with TB were more likely to have hypoechoic and matted nodes[40 patients(67.7%)].EUS-FNA/B was found to have a sensitivity and specificity of 86%and 93%respectively,with a diagnostic accuracy of 88%in the evaluation of intra-abdominal lymphadenopathy due to TB.CONCLUSION EUS-FNA/B has a high diagnostic yield with a good sensitivity and specificity in the evaluation of intra-abdominal lymphadenopathy due to TB.However,the validity of these findings in populations with low prevalence of TB needs further evaluation.

关 键 词：Endoscopic ultrasound Lymph nodes TUBERCULOSIS MESENTERIC INTRAABDOMINAL 

分 类 号：R521[医药卫生—内科学] R551.2[医药卫生—临床医学]