Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing mediastinal lymphadenopathy

Gahlot, T. K.; Parakh, Ujjwal; Verma, Kusum; Bhalotra, Bobby; Jain, Neeraj

doi:10.4103/0970-2113.205339

Cited by 17 publications

(16 citation statements)

References 38 publications

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“…The combination of EBUS and contrast-enhanced chest CT to select promising nodes for biopsy has made this technique increasingly more precise, with enhanced sensitivity, specificity, and accuracy. Many studies worldwide have examined the sensitivity, specificity, and safety of EBUS-TBNA for diagnosing mediastinal large lymph node etiology, demonstrating its superiority and highlighting the integral role of this technique in clinical contexts, in addition to describing its development potential [13] , [14] , [15] , [16] , [17] , [18] .…”

Section: Discussionmentioning

confidence: 99%

Primary mediastinal lymph node tuberculosis diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration: Literature review and case report

Cong

Anh

et al. 2022

Radiology Case Reports

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Section: Discussionmentioning

confidence: 99%

Primary mediastinal lymph node tuberculosis diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration: Literature review and case report

Cong

Anh

et al. 2022

Radiology Case Reports

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“…[9][10][11] Out of the non-malignant mediastinal lesions in the general population, reactive lymphadenitis is the second most common aetiology following granulomatous disease. [10][11][12] In our study too, although being done in a tertiary care referral cancer centre, and thus, having a selection bias in the study cohort, we found the commonest cause of non-metastatic mediastinal lesion to be reactive lymphadenitis followed by granulomatous inflammation. In the present study we found the non-metastatic lesions to be more prevalent than metastatic lesions (61.9% non-metastatic disease versus 38.1% metastatic disease on EBUS staging).…”

Section: Discussionmentioning

confidence: 99%

Mediastinal Sampling with Endobronchial Ultrasound in Cancer Patients: Is It Always Metastatic?

Dabkara¹,

Midha²,

Chatterjee³

et al. 2022

The Indian Journal of Chest Diseases and Allied Sciences

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Objective. The overall management and prognosis of a cancer patient depends on the histopathology, molecular genetics and staging of the disease. Staging refers to the size and the spread of the cancer. Knowing the stage of the cancer helps us to determine the natural history of the disease and median survival. It also helps us plan the best treatment for the patient. Mediastinal staging with invasive modalities, like endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become important for appropriate tissue sampling in patients with mediastinal involvement in various benign and malignant diseases. Methods.A retrospective, cross-sectional study was done in a single tertiary care cancer centre from January, 2018 to December, 2018.The patients were referred for mediastinal staging and/or for diagnostic evaluation. The procedure EBUS-TBNA with rapid on-site evaluation (ROSE) was done for 123 patients as a day-care procedure in the bronchoscopy suite of the institution.Results. Out of the total of 123 cases that underwent EBUS, 119 patients had an EBUS-TBNA for lymph node assessment. Staging in lung cancer, breast cancer, colon cancer, renal cell carcinoma was done in 63 (52.9%) cases and diagnostic evaluation of either a mediastinal mass lesion or a lung mass with mediastinal extension of lymph nodal involvement was done in 56 (47.1%) cases. Out of the 63 cases those underwent EBUS-TBNA for staging, 39 (61.9%) cases were non metastatic; 15 (38.4%) were diagnosed with granulomatous inflammation and 24 (61.5%) cases had reactive lymphadenitis. The remaining 24 of 63 cases had metastatic disease. Out of the 56 cases for diagnostic evaluation, 17 (30.3%) had granulomatous inflammation, 7 (12.5%) had reactive lymphadenitis and 32 (57.1%) had malignant disease.Conclusions. Tissue pathology is always the crux to label a patient with the appropriate diagnosis. Moreover, accurate tissue sampling is important for mediastinal nodes in a diagnosed malignant disease, like lung cancer and breast cancer. This will help in appropriate staging and choose the proper treatment strategy.

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“…The gold standard method for invasive mediastinal lymph nodes (LNs) staging in lung cancer was mediastinoscopy. However, the introduction of the convex probe, in the early 2000s, has transformed the technique of mediastinal LN staging in lung cancer, as it allows real-time TBNA of the visualized tissue 3 .…”

Section: Introductionmentioning

confidence: 99%

The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study

Bonert

Zafar

Ramadan

et al. 2023

Sci Rep

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Mediastinal lymph node fine needle aspiration (MLN-FNA) is a common procedure; however, the physician factor in pathological category, and anatomical site are not routinely assessed. Cytology reports for endobronchial ultrasound (EBUS)/endoscopic ultrasound (EUS) MLN-FNA specimens (8846) were retrieved for July 2012–Dec 2019, classified by hierarchical free text string match algorithm into 51 diagnostic categories, four mutually exclusive diagnostic groups (benign |suspicious |malignant |insufficient), and 24 anatomical sites. Pathologist and submitting physician/surgeon bias were assessed using logistic regression and funnel plots|control charts centered on the group median (diagnostic/capture) rate. Eleven pathologists and seven submitting physician/surgeon were involved in more than 250 specimens each. Overall, the MLN-FNAs were benign|suspicious|malignant|insufficient in 46%|4%|25%|24% of specimens. Percent malignant (number of samples) varied by station; 7| 4R| 4L| 2R| 10R| 11R| 11L were respectively 21%(3,101), 27%(2,453), 19%(1,289), 41%(435), 27%(497), 24%(357), 26%(229). The number of outlier (P < 0.05/P < 0.001) pathologists of 11 from the group median rate for benign|suspicious|malignant|insufficient was 0/0| 3/1| 0/0| 3/0 respectively. The outlier (P < 0.05/P < 0.001) submitting physicians/surgeons of 7 for benign|suspicious|malignant|insufficient was 3/2| 2/2| 3/2| 3/2 respectively. The physician and anatomical site are significant predictors of MLN-FNA pathology.

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Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing mediastinal lymphadenopathy

Cited by 17 publications

References 38 publications

Primary mediastinal lymph node tuberculosis diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration: Literature review and case report

Primary mediastinal lymph node tuberculosis diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration: Literature review and case report

Mediastinal Sampling with Endobronchial Ultrasound in Cancer Patients: Is It Always Metastatic?

The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study

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