Accuracy of TB-PCR using endobronchial ultrasound guided trans-bronchial needle aspiration (EBUS-TBNA) samples in mediastinal granulomatous lymphadenopathy

Dutt, Tiyas Sen; Tousheed, Syed Zulkharnain; Annapandian, VM

doi:10.1016/j.ijtb.2021.09.002

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…US-TCNB appeared to maintain a competitive diagnostic accuracy compared to other biopsy techniques, both surgical and percutaneous. Its diagnostic values were comparable to those of more invasive surgical procedures-Anterior Mediastinotomy and Video-Assisted Thoracoscopy (94 vs. 96 and 98%, respectively) [16,26]-and percutaneous techniques-Trans-Bronchial Needle Aspiration, CT-guided core needle biopsy and MRI-Guided Biopsy (94 vs. 93, 94 and 88%, respectively) [22,27,28].…”

Section: Discussionmentioning

confidence: 62%

Ultrasound-Guided Needle Biopsy as an Alternative to Chamberlain’s Mediastinotomy and Video-Assisted Thoracoscopic Surgery (VATS) in the Diagnosis of Anterior Mediastinal Neoformations: A Retrospective Analysis

Vischia

Maio

Ferrero

et al. 2023

JCM

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(1) Background: The prompt diagnosis of anterior mediastinal lesions is a challenge due to their often being categorized as malignant tumours. Ultrasound-guided Transthoracic Core Needle Biopsy (US–TCNB) is an innovative technique that is arousing increasing interest in clinical practice. However, studies in this area are still scarce. This study aims to compare the diagnostic accuracy and complication rate of US–TCNB with those of traditional surgical methods—Anterior Mediastinotomy and Video Assisted Thoracoscopic Surgery (VATS)—in patients with anterior mediastinal lesions. (2) Methods: This retrospective study involved patients evaluated between January 2011 and December 2021 who had undergone US–TCNB at the Interdepartmental Unit of Internal and Interventional Ultrasound, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy. Personal data, diagnostic questions, and technical information concerning the bioptic procedure, periprocedural complications and histological reports were collected. (3) Results: Eighty-three patients were included in the analysis. Histological examination was performed in 78 cases, with an overall diagnostic accuracy of 94.0% (sensitivity 94%; specificity 100%). Only in 5 patients was a diagnosis not achieved. Complications occurred in 2 patients who were quickly identified and properly treated without need of hospitalization. The accuracy of US–TCNB was comparable to the performance of the main traditional diagnostic alternatives (95.3% for anterior mediastinotomy, and 98.4% for VATS), with a much lower complication rate (2.4% vs. 3–16%). The outpatient setting offered the additional advantage of saving resources. (4) Conclusions: a US-guided needle biopsy can be considered effective and safe, and in the near future it may become the procedure of choice for diagnosing anterior mediastinal lesions in selected patients.

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Section: Discussionmentioning

confidence: 62%

Ultrasound-Guided Needle Biopsy as an Alternative to Chamberlain’s Mediastinotomy and Video-Assisted Thoracoscopic Surgery (VATS) in the Diagnosis of Anterior Mediastinal Neoformations: A Retrospective Analysis

Vischia

Maio

Ferrero

et al. 2023

JCM

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“…GeneXpert Mtb PCR has good specificity (even if false positives can be obtained with PCR Mtb due to contamination) but its sensitivity is not always optimal (ranging from 50 to 100%) in non-pulmonary specimens, as already revealed in a lot of studies and particularly in Dhooria et al's study (49.1%) [4][5][6]. In our study, PCR was positive in 93% of the tuberculosis cases but we included pulmonary samples (sputum; bronchoalveolar lavage), peritoneal fluid, cerebrospinal fluid, bone samples and not exclusively lymph node samples.…”

Section: Discussionmentioning

confidence: 94%

“…The role of GeneXpert ® PCR has also been established in extra-pulmonary samples. In lymph node samples, sensitivity ranged from 50% to 100%, whereas for cerebrospinal fluid (TB meningitis), the pooled sensitivity and specificity were 62.8% and 98.8%, respectively [4][5][6]. For the diagnosis of joint TB, the sensitivity and specificity of GeneXpert ® PCR were 82.65% and 91.00% [4].…”

Section: Introductionmentioning

confidence: 99%

A Comparison Study of Lymph Node Tuberculosis and Sarcoidosis Involvement to Facilitate Differential Diagnosis and to Establish a Predictive Score for Tuberculosis

Hoornaert,

Yildiz,

Pothen

et al. 2024

Pathogens

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Background: Tuberculosis (TB) and sarcoidosis are two common granulomatous diseases involving lymph nodes. Differential diagnosis is not always easy because pathogen demonstration in tuberculosis is not always possible and both diseases share clinical, radiological and histological patterns. The aim of our study was to identify factors associated with each diagnosis and set up a predictive score for TB. Methods: All cases of lymph node tuberculosis and sarcoidosis were retro-spectively reviewed. Demographics, clinical characteristics, laboratory and imaging data, and mi-crobiological and histological results were collected and compared. Results: Among 441 patients screened, 192 patients were included in the final analysis. The multivariate analysis showed that weight loss, necrotic granuloma, normal serum lysozyme level and hypergammaglobulinemia were significantly associated with TB. A risk score of TB was built based on these variables and was able to discriminate TB versus sarcoidosis with an AUC of 0.85 (95%CI: 0.79–0.91). Using the Youden’s J statistic, its most discriminant value (−0.36) was associated with a sensitivity of 80% and a specificity of 75%. Conclusion: We developed a score based on weight loss, necrotic granuloma, normal serum lysozyme level and hypergammaglobulinemia with an excellent capacity to discriminate TB versus sarcoidosis. This score needs still to be validated in a multicentric prospective study.

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Accuracy of TB-PCR using endobronchial ultrasound guided trans-bronchial needle aspiration (EBUS-TBNA) samples in mediastinal granulomatous lymphadenopathy

Cited by 2 publications

References 21 publications

Ultrasound-Guided Needle Biopsy as an Alternative to Chamberlain’s Mediastinotomy and Video-Assisted Thoracoscopic Surgery (VATS) in the Diagnosis of Anterior Mediastinal Neoformations: A Retrospective Analysis

Ultrasound-Guided Needle Biopsy as an Alternative to Chamberlain’s Mediastinotomy and Video-Assisted Thoracoscopic Surgery (VATS) in the Diagnosis of Anterior Mediastinal Neoformations: A Retrospective Analysis

A Comparison Study of Lymph Node Tuberculosis and Sarcoidosis Involvement to Facilitate Differential Diagnosis and to Establish a Predictive Score for Tuberculosis

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