P-LUM-04: Retrospective analysis of endoscopic ultrasound-guided fine needle aspiration for lymph nodes in a tertiary center in india in the last 3 years: Assessment of efficacy, attainment of core biopsy and to see the disease trend in western india

METHODS: All patients for lymph node assessment were subjected to endoscopic ultrasound-guided fine needle aspiration (EUS FNA) and core biopsy. First pass made with a stylet and the subsequent passes without the stylet. First two passes were made with a 22-gauge needle, material taken for cytology. Third and the fourth pass were made with 19-gauge needle and material taken for core biopsy in formalin. Fifth pass was made with 19-gauge needle and material taken in saline for GeneXpert and SOS acid-fast bacilli (AFB). RESULTS: Total number of patients was 72. The most common sites were mediastinum - 26, peripancreatic nodes - 39, celiac - 05, and nodes at porta - 2. Positive Diagnosis: 70 (97.2%) Inconclusive: 2 (2.8%) Diagnostic Trends: Tuberculosis: 42 (58.3%) Metastatic Carcinoma: 18 (25%) Lymphoma: 6 (5.6%) Inflammatory: 2 (2.8%) Core Biopsy: Total: 72 Granuloma with Caseation seen: 25 (59.5%) Gene Xpert positive: 17 (40.5%) immunohistochemistry (IHC) Possible in Lymphoma Cases: 4 (66.7%) Need for repeat core biopsy: 2 (33.3%) Blood contamination: 60 (83.3%). CONCLUSION: EUS FNA and fine needle biopsy are effective modalities for the assessment of mediastinal and abdominal nodes, with a high accuracy of 97.2%. Adequate core biopsy is obtained for GeneXpert, AFB culture in up to 90% cases. In cases of lymphoma, the core obtained gave positive IHC grading in 66.7% cases, suggesting a need for a better core biopsy needle. Blood contamination remains a problem for the pathologist in core taken with a 19-gauge needle.