Predictive Factors for Inaccurate Diagnosis of Swollen Lymph Nodes in Endoscopic Ultrasound-Guided Fine Needle Aspiration

Background/Aims This study aimed to identify the predictive factors for inaccurate endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnosis of swollen lymph nodes without rapid on-site cytopathological evaluation. Methods Eighty-three consecutive patients who underwent EUS-FNA for abdominal or mediastinal lymph nodes from January 2008 to June 2017 were included from a prospectively maintained EUS-FNA database and retrospectively reviewed. The sensitivity, specificity, and accuracy of EUS-FNA for the detection of neoplastic diseases were calculated. Candidate factors for inaccurate diagnosis (lymph node size and location, needle type, puncture route, number of passes, and causative disease) were evaluated by comparison between accurately diagnosed cases and others. Results The final diagnosis of the punctured lymph node was classified as neoplastic (65 cases: a metastatic lymph node, malignant lymphoma, or Crow-Fukase syndrome) or non-neoplastic (18 cases: a reactive node or amyloidosis). The sensitivity, specificity, and accuracy were 83%, 94%, and 86%, respectively. On multivariate analyses, small size of the lymph node was the sole predictive factor for inaccurate EUS-FNA diagnosis with a significant difference (odds ratios, 19.8; 95% confidence intervals, 3.15–124; p=0.0015). Conclusions The lymph node size of <16 mm was the only independent factor associated with inaccurate EUS-FNA diagnosis of swollen lymph nodes

Effects of Heating Rate on Formation of Globular and Acicular Austenite during Reversion from Martensite

The effects of heating rate on the formation of acicular and globular austenite during reversion from martensite in Fe&#8315;2Mn&#8315;1.5Si&#8315;0.3C alloy have been investigated. It was found that a low heating rate enhanced the formation of acicular austenite, while a high heating rate favored the formation of globular austenite. The growth of acicular &#947; was accompanied by the partitioning of Mn and Si, while the growth of globular &#947; was partitionless. DICTRA simulation revealed that there was a transition in growth mode from partitioning to partitionless for the globular austenite with an increase in temperature at high heating rate. High heating rates promoted a reversion that occurred at high temperatures, which made the partitionless growth of globular austenite occur more easily. On the other hand, the severer Mn enrichment into austenite at low heating rate caused Mn depletion in the martensite matrix, which decelerated the reversion kinetics in the later stage and suppressed the formation of globular austenite