The role of endobronchial ultrasound-guided transbronchial needle aspiration in the differential diagnosis of isolated mediastinal and/or hilar lymphadenopathy.
Diagn Cytopathol
; 49(9): 1012-1021, 2021 Sep.
Article
em En
| MEDLINE
| ID: mdl-34078002
ABSTRACT
INTRODUCTION:
Isolated mediastinal and/or hilar lymphadenopathy (IMHL) has become an increasingly common finding as a result of the increased use of thoracic imaging modalities. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is accepted as the first step diagnostic method in the differential diagnosis of IMHL.OBJECTIVE:
To determine the diagnostic yield of the procedure and to analyze clinical and sonographic findings that can be used to differentiate the etiology of lymph node pathologies.METHODS:
Patients who underwent EBUS-TBNA procedure between March 2017 and March 2020 were included in this retrospective study. Demographic data, symptoms, comorbid diseases, and EBUS findings were obtained from the records of the patients.RESULTS:
EBUS-TBNA provided a diagnosis in 88 patients out of 120 patients (granulomatous diseases n = 54, malignant diseases n = 21, and anthracotic lymph nodes n = 13), and 32 patients had a negative EBUS-TBNA. 22/32 negative EBUS-TBNA samples were true negatives (reactive lymphadenopathy). The sensitivity of the procedure was 89.8% while negative predict value was 68.7%, diagnostic yield of 91.6%. Patients with reactive lymph nodes had significantly more comorbidities (77.3%-19.4%, p < .001) and a lower number of lymph node stations (1.6 ± 0.8-2.7 ± 0.9, p < .001). Patients with anthracotic lymph nodes were older and mostly consisted of females (11/13, p < .001).CONCLUSION:
EBUS-TBNA has high-diagnostic efficiency in the differential diagnosis of IMHL. The number and size of lymph node stations can provide useful information for differential diagnosis. Clinical follow-up can be a more beneficial approach in patients with reactive and anthracotic lymph nodes before invasive sampling.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico
/
Linfadenopatia
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Diagn Cytopathol
Ano de publicação:
2021
Tipo de documento:
Article