Release Date: May 2017
CC: PC, MK, PBL, SBP
Lester J. Layfield, MD, FASCP
Professor and Chair, University of Missouri, Columbia, MO
EUS and EBUS are the predominant guidance methodologies for cytologic sampling of the pancreaticobiliary system and for lesions of the lung and hilar lymph nodes. The relative ease of the procedure and their ability to sample otherwise difficult anatomic sites greatly enhances the procedures' value. While EUS and EBUS were originally developed to sample primary lesions within the pancreaticobiliary system and the lungs, their utility for sampling lymph nodes in the hilar, mediastinal, and upper abdominal areas has led to their utilization for nodal sampling and staging. EBUS is used frequently for investigation of lymph nodes and has been shown to be a safe and effective method for staging of lung cancers. Similarly, endoscopic ultrasound guided FNA can sample lymph nodes in the vicinity of the pancreas and liver for establishing the presence of metastatic disease. In both the chest and upper abdominal sites, fine needle aspiration may inadvertently detect primary lymphoid lesions instead of the clinically suspected metastatic disease. Appropriate workup of these specimens following rapid on-site evaluation can lead to definitive diagnoses of lymphoma. Obtaining adequate material for flow cytometry and molecular techniques is critical to the successful cytologic diagnosis of primary lymphoid lesions.
After attending this session, participants will be able to:
· Know lymph node groups accessible by EUS and EBUS.
· Understand the importance of EBUS node sampling for staging of lung cancers.
· Understand the utility of EUS for detection of metastatic disease and staging for carcinomas of the pancreas, liver, and stomach.
· Understand how to work-up FNAs of primary lymphoid lesions sampled by EUS and EBUS.
Who should attend? Practicing Pathologists, Residents, Cytotechnologists