The utility of endobronchial ultrasound-transbronchial needle aspiration in lymphoma

Abstract

Background and Objectives:Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure that has a well-established role in the diagnosis and staging of lung cancer. This technology is also widely used for the diagnosis of mediastinal masses and cysts as well as other inflammatory disorders such as sarcoidosis. However, the utility of this procedure in the diagnosis and subclassification of lymphoproliferative disorders (LPDs) is not clear. We performed a systematic review to evaluate EBUS-TBNA use in LPDs.Materials and Methods:PubMed, EMBASE, MEDLINE, Cochrane Library Plus, and ISI Web of Knowledge were searched for studies of clinical trials in English reporting diagnostic performance of EBUS-TBNA in lymphoma until September 2014. The overall sensitivity, negative predictive value (NPV), and diagnostic accuracy were evaluated.Results:Six trials involving 346 patients with suspected lymphoma were included. The overall sensitivity, NPV, and diagnostic accuracy ranged 38%-91%, 83%-96.4%, and 91%-97%, respectively. Further invasive surgery was needed only in 13-43% of the patients. None of the studies included in the present review reported important complications.Conclusion:Current evidence suggests that EBUS-TBNA can be used as an initial evaluation for patients with suspected lymphoma. Additional surgical procedures may be necessary if a sample is inadequate or negative with high suspicion of lymphoma. Further multicenter trials are needed to evaluate the diagnostic yield of EBUS-TBNA in lymphoma patients.

Initial Polish Experience of Flexible 19 Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

“…The quality of CB samples are highly promising especially for ALK, ROS1 and PD-L1 typing, when bigger samples are needed. A complication rate observed in our study was comparable with the standard EBUS-TBNA [1,2,[6][7][8].…”

“…EBUS-TBNA is also successfully performed for diagnostic purposes in patients with paratracheal and peribronchial tumours [2,3].…”

Utility of endobronchial ultrasound‐guided transbronchial needle aspiration in diagnosing non‐specific inflammatory intrathorcacic lymphadenitis

“…14 There were studies show that EBUS-TBNA could be useful in diagnosing lymphoma with sensitivity arrange from 76% to 90.9%, 4,15 however, recent research reported that reactive LN diagnosed by EBUS-TBNA was confirmed as lymphoma by thoractomy. 16 More biopsy specimens, flow cytometry and immunohistology could help raise diagnostic yield of EBUS-TBNA for lymphoma.…”

“…[3][4][5][6][7][8][9] Less is known, however, about the utility of EBUS-TBNA for diagnosing non-specific intrathoracic inflammatory lymphadenopathy. Pathology and microbiology play distinct roles in diagnosing non-specific intrathoracic lymphadenitis.…”

Pathway and application value of exploration of the pulmonary artery by endobronchial ultrasound

“…The clinical application of EBUS is principally guiding TBNA (11)(12)(13)(14)(15). Some investigators used EBUS as a tool for detecting pulmonary vascular abnormalities, including the pulmonary thromboembolism and non-thromboembolic pulmonary vascular diseases.…”