9 research outputs found

    A Rare Nasopharyngeal Presentation of Amyloidosis

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    Amyloidosis is a heterogeneous group of diseases characterized by the extracellular deposition of insoluble proteins whose pathogenesis is not yet fully understood. The deposition of amyloid proteins can be systemic or localized, idiopathic or related to systemic diseases, mostly multiple myeloma or chronic inflammatory diseases. Localized head and neck amyloidosis is a rare entity, mainly involving the larynx. Given the rarity of the disease and the absence of a lasting follow-up protocol, there is no standard treatment defined for localized amyloidosis. We report a rare case of localized nasopharyngeal amyloidosis, treated with complete transoral resection and confirmed by histological examination

    Diagnostic Accuracy and Safety of Endoscopic Ultrasound-Guided End-cutting Fine-needle Biopsy needles for tissue sampling of Abdominal and Mediastinal Lymphadenopathies: a prospective multicenter series

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    Background and aims: The role of the newer EUS-fine needle biopsy (FNB) needles in lymphadenopathies (LA) is still under evaluation. We aimed to evaluate the diagnostic accuracy and the adverse event rate of EUS-FNB in diagnosing LA. Methods and patients: From June 2015 to 2022, all patients referred to 4 institutions for EUS-FNB of mediastinal and abdominal LA were enrolled. 22G Franseen tip or 25G Fork tip needles were used. The gold standard for positive results was surgery or imaging and clinical evolution over a follow-up of at least one year. Results: A total of 100 consecutive patients were enrolled, consisting of those with a new diagnosis of LA (40%), presence of LA with a previous history of neoplasia (51%), or suspected lymphoproliferative disease (9%). EUS-FNB was technically feasible in all LA patients with 2 to 3 passes (mean 2.62±0.93). The overall EUS-FNB sensitivity, positive predictive value (PPV), specificity, negative predictive value (NPV), and accuracy were 96.20%, 100%, 100%, 87.50%, and 97.00%, respectively. Histological analysis was feasible in 89% of cases. Cytological evaluation was performed in 67% of specimens. There was no statistical difference between the accuracy of the 22G or 25G needle (p=0.63). A sub-analysis on lymphoproliferative disease revealed a sensitivity and accuracy of 89.29% and 90.0%. No complications were recorded. Conclusions: EUS-FNB with new end-cutting needles is a valuable and safe method to diagnose LA. The high quality of histological cores and the good amount of tissue allowed a complete immunohistochemical analysis of metastatic LA and precise subtyping of the lymphomas