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2000
Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Background

Mediastinal and hilar lesions may be benign or malignant. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is increasingly used for the diagnosis of these lesions as it is both minimally invasive and safe.

Objective

To investigate the clinical efficacy of EBUS-TBNA in the diagnosis and differential diagnosis of mediastinal and hilar lesions.

Methods

A retrospective observational study was undertaken to investigate patients diagnosed with mediastinal and hilar lymphadenopathy based on imaging at our hospital from 2020 to 2021. After evaluation, EBUS TBNA was used and data including the puncture site, postoperative pathology, and complications were recorded.

Results

Data from 137 patients were included in the study, of which 135 underwent successful EBUS TBNA. A total of 149 lymph node punctures were performed, of which 90 punctures identified malignant lesions. The most common malignancies were small-cell lung carcinoma, adenocarcinoma, and squamous cell carcinoma. Forty-one benign lesions were identified, resulting from sarcoidosis, tuberculosis, and reactive lymphadenitis, amongst others. Follow-up findings showed that 4 cases were malignant tumors, with 1 case of pulmonary tuberculosis and 1 case of sarcoidosis). Four specimens where lymph node puncture was insufficient were subsequently confirmed by other means. The sensitivity of EBUS TBNA for malignant lesions, tuberculosis and sarcoidosis in mediastinal and hilar lesions was 94.7%, 71.4%, and 93.3%, respectively. Similarly, the negative predictive values (NPV) were 88.9%, 98.5%, and 99.2%, and the accuracy was 96.3%, 98.5%, and 99.3%.

Conclusion

EBUS TBNA is an effective and feasible approach for the diagnosis of mediastinal and hilar lesions that is minimally invasive and safe.

© 2024 The Author(s). Published by Bentham Open. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2023-07-07
2025-01-18
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References

  1. DincerH.E. Linear EBUS in staging non-small cell lung cancer and diagnosing benign diseases.J. Bronchology Interv. Pulmonol.2013201667610.1097/LBR.0b013e31827d151423328148
    [Google Scholar]
  2. DivisiD. ZaccagnaG. BaroneM. GabrieleF. CrisciR. Endobronchial ultrasound-transbronchial needle aspiration (EBUS/TBNA): A diagnostic challenge for mediastinal lesions.Ann. Transl. Med.201865929910.21037/atm.2017.12.1929666815
    [Google Scholar]
  3. PetranovicM. GilmanM.D. MuniappanA. HasserjianR.P. DigumarthyS.R. MuseV.V. SharmaA. ShepardJ.A.O. WuC.C. Diagnostic yield of CT-guided percutaneous transthoracic needle biopsy for diagnosis of anterior mediastinal masses.AJR Am. J. Roentgenol.2015205477477910.2214/AJR.15.1444226397325
    [Google Scholar]
  4. El-SheriefA.H. LauC.T. WuC.C. DrakeR.L. AbbottG.F. RiceT.W. International association for the study of lung cancer (IASLC) lymph node map: Radiologic review with CT illustration.Radiographics20143461680169110.1148/rg.34613009725310423
    [Google Scholar]
  5. ConteS.C. SpagnolG. BioloM. ConfalonieriM. A retrospective study of endobronchial ultrasound transbronchial needle aspiration versusconventional transbronchial needle aspiration in diagnosis/staging of hilar/mediastinal lymph node in lung cancer: Which role in clinical practice?Monaldi Arch. Chest Dis.20198911010101410.4081/monaldi.2019.101030996353
    [Google Scholar]
  6. LinC.K. KengL.T. LimC.K. LinY.T. LinS.Y. ChenL.Y. YaoZ.H. ChenY.H. HoC.C. Diagnosis of mediastinal tuberculous lymphadenitis using endobronchial ultrasound-guided transbronchial needle aspiration with rinse fluid polymerase chain reaction.J. Formos. Med. Assoc.2020119150951510.1016/j.jfma.2019.07.01431377114
    [Google Scholar]
  7. KasperL. AndrychiewiczA. Gross-SondejI. SojaJ. KasperM. TomaszewskaR. UrbanczykK. SladekK. Combination of endosonography-guided fine-needle aspiration and conventional endoscopic techniques in sarcoidosis diagnosis. Optimal strategy to achieve high diagnostic yield.Clin. Respir. J.202115220320810.1111/crj.1328533012129
    [Google Scholar]
  8. ErerO.F. AnarC. ErolS. ÖzkanS. The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy.Turk. J. Med. Sci.201646111211910.3906/sag‑1407‑11327511343
    [Google Scholar]
  9. ŽemaitisM. MusteikienėG. MiliauskasS. PranysD. SakalauskasR. Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Cytological Smears and Cell Blocks: A Single-Institution Experience.Medicina (Kaunas)2018542192810.3390/medicina5402001930344250
    [Google Scholar]
  10. TemizD. İnE. KuluöztürkM. KırkılG. ArtaşG. TurgutT. DeveciF. The role of endobronchial ultrasound‐guided transbronchial needle aspiration in the differential diagnosis of isolated mediastinal and/or hilar lymphadenopathy.Diagn. Cytopathol.20214991012102110.1002/dc.2480734078002
    [Google Scholar]
  11. CarterB.W. GlissonB.S. TruongM.T. ErasmusJ.J. Small cell lung carcinoma: Staging, imaging, and treatment considerations.Radiographics20143461707172110.1148/rg.34614017825310425
    [Google Scholar]
  12. CarbonariA RossiniL MarioniF Value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of lung and mediastinal lesions.Rev Assoc Med Bras202066912101216
    [Google Scholar]
  13. GandotraS. DotsonT. LamarZ. BellingerC. Endobronchial Ultrasound Transbronchial Needle Aspiration for the Diagnosis of Lymphoma.J. Bronchology Interv. Pulmonol.20182529710210.1097/LBR.000000000000044929076937
    [Google Scholar]
  14. EickhoffL. GolponH. ZardoP. SuhlingH. WelteT. JonigkD. GottliebJ. FuehnerT. Endobronchial Ultrasound in Suspected Non-Malignant Mediastinal Lymphadenopathy.Pneumologie201872855956710.1055/a‑0583‑026529788514
    [Google Scholar]
  15. LuceyO. PotterJ. RickettsW. CastleL. MelzerM. Utility of EBUS-TBNA in diagnosing mediastinal tuberculous lymphadenitis in East London.J. Infect.2022841172310.1016/j.jinf.2021.10.01534706281
    [Google Scholar]
  16. BatumÖ. KatgıN. ÖzdemirÖ. YılmazU. Diagnostic efficacy of EBUS‐TBNA in benign diseases in a population with a high prevalence of tuberculosis.Diagn. Cytopathol.202149337438010.1002/dc.2466133197137
    [Google Scholar]
  17. ScanoV. FoisA.G. MancaA. BalataF. ZinelluA. ChessaC. PirinaP. PaliogiannisP. Role of EBUS-TBNA in Non-Neoplastic Mediastinal Lymphadenopathy: Review of Literature.Diagnostics (Basel)202212251252710.3390/diagnostics1202051235204602
    [Google Scholar]
  18. NinC.S. de SouzaV.V.S. do AmaralR.H. NetoR.S. Tronco AlvesG.R. MarchioriE. IrionK.L. BalbinotF. de Souza Portes MeirellesG. SantanaP. Portugal GomesA.C. HochheggerB. Thoracic lymphadenopathy in benign diseases: A state of the art review.Respir. Med.2016112101710.1016/j.rmed.2016.01.02126860219
    [Google Scholar]
  19. Olgun YıldızeliŞ. TufanA. BozkurtlarE. ArıkanH. KocakayaD. EryükselE. CeyhanB. KarakurtS. Endobronchial ultrasound transbronchial needle aspiration in elderly patients: Safety and performance outcomes EBUS-TBNA in elderly.Aging Male202023550751210.1080/13685538.2018.153833730457426
    [Google Scholar]
  20. DhooriaS. SehgalI.S. GuptaN. PrasadK.T. AggarwalA.N. AgarwalR. Diagnostic utility and safety of endobronchial ultrasound–guided transbronchial needle aspiration in the elderly.J. Bronchology Interv. Pulmonol.2020271222910.1097/LBR.000000000000060531206389
    [Google Scholar]
  21. GianellaP. SoccalP.M. PlojouxJ. FrésardI. PacheJ.C. PernegerT. GexG. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration in malignant and nonmalignant disease.Acta Cytol.2018625-638038510.1159/00049333430244239
    [Google Scholar]
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