Randomized study comparing conventional needle fine needle aspiration to procore biopsy needle in patients with mediastinal lymphadenopathy and masses of unknown origin

Abstract

Background and Objectives:Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is a commonly used tool in the diagnosis of mediastinal lymphadenopathy. However, less is known of the value of ProCore fine needle biopsy (FNB). This prospective, comparative study compares the outcomes of EUS-guided FNA (EUS FNA) and FNB, in patients with mediastinal lymphadenopathy and masses of unknown origin.Methods:Results were compared for cellularity and adequacy for all patients who had cytological/histological specimens taken. Patients were randomized into Group A (undergone EUS FNA only) and Group B (EUS FNA + FNB). Patients were followed up for 3 months and final diagnosis was made.Results:Sixty-one patients underwent EUS for mediastinal lymphadenopathy and had specimens taken through FNA, FNB, or both. Four patients lost to follow-up and therefore were excluded from analysis. Of the remaining 57 patients, adequacy and inadequacy of EUS FNA sample were seen in 41 (71.93%) and 16 (21.07%), respectively. Of the 29 patients undergoing both procedures, the adequacy in FNA and FNB were 20 (68.97%) and 23 (79.31%), respectively. The difference was not statistically significant (P > 0.05).Conclusions:The diagnostic sensitivity of aspirated material obtained using EUS-FNA needle and ProCore needle in mediastinal masses and lymph nodes was comparable in our study.