Endoscopic ultrasound (EUS) accurately distinguishes celiac lymph nodes (CLNs) from celiac ganglia (CG) and may be used to increase the accuracy of tumor staging, a recent study found. Researchers identified all patients from EUS and cytopathology databases who underwent EUS-FNA of a presumed CLN or CG from October 1, 2004 through March 1, 2017 and compared the findings with those from cytology. EUS imaging results were compared with those from the reference standard. Among the findings:

• 504 patients (mean age 63.4 years, 292 male) underwent a median of 7 EUS-FNA passes for a total of 566 lesions perceived to be either a CLN or CG; the cytology reference standard was available for 521 lesions (92.1%).
• The EUS accurately identified 281/286 CLNs (98.3%) and 166/186 CGs (89.2%) for an overall accuracy of 94.7% (excluding indeterminate cytology results).
• EUS-FNA distinguished CG from CLNs with a 93.3% sensitivity; 93.7% specificity, a positive value of 96.2%, and a negative predictive value of 89.2%.