Comparison of 19-gauge FNA and 22-gauge FNB needles for the EUS-guided fine-needle aspiration of the lymphadenopathy and malignant lymphoma diagnosis: A multicenter retrospective study

Background and Objectives: EUS-guided fine-needle aspiration (EUS-FNA) using a 19-gauge FNA needle can safely obtain sufficient tissue samples for the evaluation of lymphadenopathy. FNB needles can also provide adequate tissue, and 22-gauge needles are generally easier to puncture than 19-gauge needles. This study aimed to compare the diagnostic performance of 19-gauge FNA and 22-gauge FNB needles for the diagnosis of lymphadenopathy. Methods: Among the 411 patients with lymphadenopathy, 221 underwent an EUS-FNA procedure using 19-gauge FNA or 22-gauge FNB needles. Patient characteristics, puncture procedures, and the accuracy of the cytological and histological diagnoses of lymphadenopathy were analyzed. Results: There were 116 and 105 patients in the 19-gauge FNA and 22-gauge FNB groups, respectively. The median lymph node size was significantly larger in the 19-gauge FNA group (29 mm vs. 23 mm, P < 0.01). Cytological and histological accuracies were significantly higher in the 19-gauge FNA group (91% vs. 63%, P < 0.01; 93% vs. 82%, P = 0.01). Multivariate logistic regression analysis showed that the use of 19-gauge FNA was significantly associated with diagnostic accuracy (cytology: odds ratio = 5.72, P < 0.01; histology: odds ratio = 3.38, P < 0.01). For malignant lymphoma diagnosis, immunohistochemical evaluation rates were similar between groups, whereas flow cytometry and cytogenetic sensitivities were significantly higher with 19-gauge FNA (90% vs . 55%, P < 0.01; and 68% vs. 14%, P < 0.01). Post-puncture infection was observed in only 1 patient in the 19-gauge FNA group. Conclusion: The use of 19-gauge FNA needles appeared to be a good option for diagnosing lymphadenopathy, considering that no significant difference was observed in the occurrence of adverse events.