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A retrospective study on the comparative use of fine-needle biopsy and aspiration for the diagnosis and classification of malignant lymphoma in Japan
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Fumitaka Niiya, Akihiro Nakamura, Yasuo Ueda, Takafumi Ogawa, Naoki Tamai, Masataka Yamawaki, Jun Noda, Tetsushi Azami, Yuichi Takano, Masatsugu Nagahama
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Received November 28, 2024 Accepted February 9, 2025 Published online March 4, 2025
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DOI: https://doi.org/10.5946/ce.2024.320
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 Abstract
 PubReader ePub
- Background
/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for diagnosing malignant lymphoma (ML). However, the optimal needle type for maximizing the diagnostic yield and tissue quality remains unclear. We compared the diagnostic performance and histological tissue quality between fine-needle biopsy (FNB) and fine-needle aspiration (FNA) needles in EUS-TA for ML.
Methods
This retrospective study included patients who underwent EUS-TA for suspected ML. The diagnostic accuracy, histological sample quality assessed by scoring, and adverse events were compared between the FNB and FNA groups. A subgroup analysis was performed for 22-gauge needles.
Results
FNB demonstrated higher diagnostic accuracy (75%) than FNA (50%) for cytology, with 100% sensitivity for histological diagnosis compared with 78.9% for FNA. The FNB group had significantly higher diagnostic rates for the World Health Organization subclassification of ML (71.4% vs. 31.6%, p=0.037). Additionally, FNB obtained superior histological quality, with 71.4% of samples scoring 5 compared with 41.2% in the FNA group. Adverse events were minimal in both groups.
Conclusions
EUS-FNB showed better diagnostic performance and histological tissue quality than EUS-FNA for ML, particularly in obtaining adequate samples for histological evaluation and subclassification. Therefore, EUS-FNB can be safely performed. Future research with larger sample sizes and genetic testing is warranted.
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