The diagnostic value and safety of transbronchial needle aspiration biopsy in children with mediastinal lymphadenopathy

Goussard, Pierre; Gie, Robert P.; Louw, Mercia; Schubert, Pawel; Kling, Sharon; Vanker, Aneesa; Rhode, D.; Nel, E.D.; Andronikou, Savvas

doi:10.1016/s1526-0542(10)70162-7

Cited by 4 publications

(5 citation statements)

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“…Inadvertent puncture of vascular structures is a potential risk, although rarely reported. Conventional TBNA has been used successfully in the diagnosis of isolated intrathoracic tuberculous lymphadenopathy in symptomatic children aged ⩾9 months at high risk of tuberculosis [58,59]. Due to their size, younger children may only be suitable for subcarinal sampling, with a diagnostic yield of ∼50% [59].…”

Section: Discussionmentioning

confidence: 99%

“…Conventional TBNA has been used successfully in the diagnosis of isolated intrathoracic tuberculous lymphadenopathy in symptomatic children aged ⩾9 months at high risk of tuberculosis [58,59]. Due to their size, younger children may only be suitable for subcarinal sampling, with a diagnostic yield of ∼50% [59]. Older children (aged ⩾12 years) may be amenable to right paratracheal, bronchial or hilar node sampling, thereby increasing the diagnostic yield to >80% [58].…”

Section: Discussionmentioning

confidence: 99%

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ERS statement: interventional bronchoscopy in children

et al. 2017

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Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives. There is a scarcity of published evidence in this field, and in many cases the task force had to resort to the collective clinical experience of the committee to develop this statement. The highlighted gaps in knowledge underline the need for further research and serve as a call to paediatric bronchoscopists to work together in multicentre collaborations, for the benefit of children with airway disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

ERS statement: interventional bronchoscopy in children

et al. 2017

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“…MR imaging of the chest is of limited value for evaluation of mediastinal lymph nodes in children because of motion artifacts [10,11]. Biopsy is the recommended method for assessment of mediastinal lymphadenopathy, but is an invasive procedure and may be associated with sampling error [12,13].…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted MR imaging of mediastinal lymphadenopathy in children

et al. 2015

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“…This diagnostic yield was similar in HIV-infected and uninfected children. The possible reasons for the high diagnostic yield were the extensive use of BAL, the application of transbronchial needle aspiration 18 and the use of both Mycobacterium tuberculosis cultures and lately the use of molecular diagnostic methods (Gene Xpert MTB-Rif (Xpert; Cepheid, CA, USA). The reported diagnostic yield is not higher than has previously reported in children with expansile pneumonia caused by Mycobacterium tuberculosis (88% ) 19 but considerably higher than other studies that used BAL samples for Mycobacterium tuberculosis culture only (44%) 15 .…”

Section: Discussionmentioning

confidence: 99%

The indications and role of paediatric bronchoscopy in a developing country, with high prevalence of pulmonary tuberculosis and HIV

Webster

Goussard

Gie

et al. 2017

Expert Review of Respiratory Medicine

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Bronchoscopy is an important investigation in the diagnosis and management of childhood respiratory diseases widely used in high income countries. There is limited information on value of paediatric bronchoscopy in low and middle income countries (LMIC). Aims and Objectives:Aim of this study was to describe the indications, findings and complications of paediatric bronchoscopy in a middle income country with a high prevalence of tuberculosis (TB) and HIV. Methodology:A retrospective analysis of a database which included all bronchoscopies on neonates and children over a 3.5 year period (January 2010 to June 2013) in a tertiary care children's hospital in South Africa. Results and Discussion:A total of 509 bronchoscopies, of which 502 (98%) were fibre-optic bronchoscopies, were performed on neonates (2.3%) and children (median age = 18 months; range 1 day-14.6 years)( (male=58%) of which 5.1% were HIV-infected. The main indications were: large airway compression 40% (n = 204) complicated pneumonia (25 %) and persistent stridor (15 %). Pathology was observed in 64% (n = 319) of bronchoscopes . The most common pathology seen was lymph node compression of the airways (21%), and upper airway pathology (12%). Interventional procedures were performed in 112 cases (22%), the commonest being removing foreign bodies removal (30%), endobronchial lymph node enucleation (30%) and transbronchial needle aspiration (20%). No major complications occurred during or following bronchoscopy. ConclusionThe diagnostic yield of paediatric bronchoscopy did not significantly differ from those reported from high income countries emphasising the importance of paediatric bronchoscopy in the management of childhood lung disease in LMICs.

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The diagnostic value and safety of transbronchial needle aspiration biopsy in children with mediastinal lymphadenopathy

Cited by 4 publications

References 0 publications

ERS statement: interventional bronchoscopy in children

ERS statement: interventional bronchoscopy in children

Diffusion-weighted MR imaging of mediastinal lymphadenopathy in children

The indications and role of paediatric bronchoscopy in a developing country, with high prevalence of pulmonary tuberculosis and HIV

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