Technique of endoscopic ultrasonography-guided fine-needle aspiration of the lymph nodes

Endoscopic ultrasonography-guided fine-needle aspiration cytology (EUS FNA) is established as a safe, less invasive, highly sensitive and specific method for tissue diagnosis over the last few years. It assumes particular importance in the cytodiagnosis of lymph nodes in the mediastinum, celiac axis, and peripancreatic regions because of its immense potential in therapeutic decision making. The overall sensitivity and accuracy in the diagnosis of lymph nodes ranges from 80% to 93% and 82% to 92%, respectively. Because the false-positive results are rare on cytology, the specificity of EUS FNA is almost 100%. No complications have been reported with this procedure in relation to the lymph nodal punctures. Because of the increasing potential of this procedure in gastroenterology and pulmoology, especially in lung cancer, there is a need to disseminate the knowledge of this extremely useful technique. We describe the indications and explain the actual technique of performing EUS FNA on lymph nodes and discuss the published results on the topic.