Lymph nodes are the most frequent site of extrahepatic metastases for hepatocellular carcinoma
(HCC). Lymph node metastasis determines patient's management, distinguishing surgical
ones from those best suited for non-surgical management. Diagnosis cannot be completely
confirmed by imaging and operative exploration. Endoscopic ultrasound elastography
(EUS-EG) has a marked role in assessment of lymph nodes in HCC patients and optimizing
their management accordingly.
This study assessed diagnostic accuracy of EUS-EG in suspected lymph nodes in HCC potential
candidates for living donor liver transplantation (LDLT) and identifued its role in diagnosis
and staging of hepatocellular carcinoma.
The study was conducted at the Tropical Medicine department, Ain Shams University, Ain
Shams Center of Organ Transplantation (ASCOT) and Endoscopy Unit, Theodor Bilharz Research
Institute between July 2018 & May2023. The patients 24 with HCC and abdominal
lymphadenopathy were prepared for LDLT. Liver function tests, Positron emission tomography
(PET) scan, EUS-EG, EUS- guided fine needle aspiration (EUS-FNA).
The results showed the prevalence of metastatic lymph nodes by EUS-FNA was 41.7%.
EUS-EG and PET scan had same sensitivity of 80.0% in detecting metastatic lymph nodes.
But, EUS-EG had a higher specificity 85.7% compared to 57.1% specificity of PET scan.