Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies

Sanz-Santos, José; Cirauqui, Beatriz; Sánchez, Estefanía; Andreo, Felipe; Serra, Pere; Monsó, Eduard; Castellà, Eva; Llatjós, Mariona; Mesa, Mónica; Ruiz-Manzano, Juan; Rosell, Rafael

doi:10.1007/s10585-012-9556-3

Cited by 30 publications

(29 citation statements)

References 28 publications

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“…Additionally, NPV was 88.3% in this study, which was similar to the results of other studies that reported rates of between 76% and 86.9% (17,19,27,28). Five cases were diagnosed as malignancy after mediastinoscopy, although EBUS-TBNA results were reported as benign.…”

Section: Discussionsupporting

confidence: 89%

The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy

Erer¹,

Anar²,

Erol³

et al. 2016

Turk J Med Sci

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The aim of this study was to determine the diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal and hilar lymph nodes (LNs) in patients with known extrapulmonary malignancy. Materials and methods:Between March 2011 and August 2013, 378 EBUS-TBNA procedures were performed. Sixty-three (16.6%) of these were performed on known extrapulmonary malignancy patients.Results: There were 28 male and 35 female patients, with median ages of 65 years (min-max: 53-87) and 57 years (min-max: 39-76), respectively. From the 63 cases, 138 lymph nodes (LNs) were sampled with EBUS-TBNA (median: 2 LNs/patient; min-max: 1-4). Results of EBUS-TBNA revealed malignancy in 18 (28.5%) and nonmalignancy in 45 (71.5%). In the nonmalignant group, there were false negatives in 5 (7.9%), anthracosis in 13 (20.6%), reactive adenitis in 16 (25.3%), sarcoidosis in 7 (11.1%), and tuberculosis in 2 (3.1%), and 2 were not evaluated (lost to follow-up) (3.1%). The diagnostic sensitivity, accuracy, and negative predictive value of EBUS-TBNA per patient were 78.2%, 91.8%, and 88.3%, respectively. Conclusion:EBUS-TBNA is a safe, minimally invasive, and effective method and can be considered as the initial test for the histopathological diagnosis of mediastinal and hilar lymphadenopathy in patients with extrapulmonary malignancy.

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Section: Discussionsupporting

confidence: 89%

The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy

Erer¹,

Anar²,

Erol³

et al. 2016

Turk J Med Sci

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“…It is a relatively simple and safe method to see beyond the bronchial tree. The importance of TBNA in the diagnosis of lung cancer and mediastinal lymph node staging has been widely accepted [5][6]. However, only few studies have been conducted on the importance of TBNA in the diagnosis and differential diagnosis of mediastinal lesions in patient with recurrent ovarian cancer and without lung abnormalities [7][8].…”

Section: Discussionmentioning

confidence: 99%

Rare recurrent ovarian cancer presented with solitary mediastinal lymph node involvement and diagnosed by transbronchial needle aspiration: a case report

Chen¹,

Qiang²,

Mei³

et al. 2013

Pulmonol Respir Res

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We report a case of ovarian cancer with post operative solitary mediastinal lymph node metastasis, which was diagnosed by transbronchial needle aspiration (TBNA). A 64 year-old female was referred to hospital with a complaint of menorrhea. Serum CA125 titre was more than 500 U/mL. Surgical resection was undertaken based on MRI, suggesting it's an ovarian cancer. Subsequently, she underwent postoperative-chemotherapy and a follow-up. 2 years post operatively, the only clinical abnormality was a solitary enlarged mediastinal lymph node and increase in the levels of serum CA125. TBNA was performed, and cytology revealed an adenocarcinoma. We diagnosed the patient to recurrence of ovarian cancer, which exhibited solitary mediastinal lymph node enlargement.

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“…Sanz-Santos et al (20), in their recently published study that included 117 patients, similarly reported that the sensitivity of EBUS-TBNA in the diagnosis of extrathoracic malignancy with mediastinal metastases was 86.4% and NPV was 75%. In a recently published review, all studies published up to 2014 concerning the value of EBUS-TBNA in determining extrathoracic malignancies with intrathoracic metastases were investigated, and a total of six studies that had a minimum of 30 patients and at least 6 months follow-up were included in the meta-analysis.…”

Section: N (%)mentioning

confidence: 98%

“…Nevertheless, there are still a few studies demonstrating the use of EBUS-TB-NA in determining the intrathoracic metastases of extrathoracic malignancies (12,(17)(18)(19)(20). In a retrospective study including 92 patients, the sensitivity of EBUS-TBNA was 85% (17); a similar study, in which 161 patients were included, found the sensitivity to be 87% and NPV to be 73% (12).…”

Section: N (%)mentioning

confidence: 99%

Efficacy of Endobronchial Ultrasound-Guided Transbronchial Needle Biopsy for the Diagnosis of Intrathoracic Lymph Node Metastases from Extrathoracic Malignancies

Öztürk¹,

Yılmaz²,

Aktaş³

et al. 2017

Eurasian J Pulmonol

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Objective: Intrathoracic lymph node enlargement is common among patients with extrathoracic malignancies. While endobronchial ultrasound-guided-transbronchial needle aspiration (EBUS-TBNA) is often used for diagnosing mediastinal or hilar lymph nodes and for staging lung cancer, there are still a few studies demonstrating the use of EBUS-TBNA for determining intrathoracic metastases from extrathoracic malignancies. The aim of this study is to evaluate the role of EBUS-TBNA for the diagnosis of extrathoracic malignancies. Methods:From March 2010 to July 2015, 190 patients with known extrathoracic malignancy, who underwent diagnostic convex probe (CP)-EBUS-TBNA due to suspicion of metastases, were included in the study. The patients' data were retrospectively investigated. Results:The findings of EBUS-TBNA were examined; 61 patients (32%) were malignant, 121 (63%) were benign, and 3 (1.5%) were not diagnostic. Five patients (3.5%) were not sampled because of the millimetric size of the lymph nodes. There was no progression at the 12-month follow-up in these patients. Among the malignancy patients, 40 had extrathoracic malignancy-related intrathoracic metastases. The diagnosis of the lymph nodes with EBUS-TBNA and the final diagnosis at follow-up are given as summarized. The size of the lymph node decreased during clinical follow-up in one of the three non-diagnostic patients (accepted as having reactive lymph node). The other two patients were diagnosed as malignant using mediastinoscopy (having esophageal cancer and squamous cell lung cancer). The sensitivity was found to be 95.3%, specificity was 100%, the negative predictive value was 97.6%, and the diagnostic accuracy rate was 98.4%. Conclusion:EBUS-TBNA is a simple, reliable, and adequate diagnostic method for determining intrathoracic lymph node metastases related to known extrathoracic malignancies.

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Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies

Cited by 30 publications

References 28 publications

The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy

The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy

Rare recurrent ovarian cancer presented with solitary mediastinal lymph node involvement and diagnosed by transbronchial needle aspiration: a case report

Efficacy of Endobronchial Ultrasound-Guided Transbronchial Needle Biopsy for the Diagnosis of Intrathoracic Lymph Node Metastases from Extrathoracic Malignancies

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