RT Journal Article
SR Electronic
T1 Granulomatous reaction – A common cause of mediastinal and hilar lymphadenopathy in non-pulmonary malignancies
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2829
VO 38
IS Suppl 55
A1 Arve Sundset
A1 Inga Leuckfeld
A1 Petter Giæver
A1 Peter Jebsen
A1 Anne Naalsund
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2829.abstract
AB Intoduction: Patients with non-pulmonary malignancies are followed with CT for exclusion of metastatic disease. Enlarged mediastinal or hilar lymph nodes can be signs of metastases.Aim: We report the outcome of 45 consecutive patients referred for EBUS-TBNA due to enlarged mediastinal or hilar lymph nodes detected on CT at clinical follow-up for non-pulmonary malignancies.Material and methods: EBUS-TBNA was performed 17 (0.5-116) months (median with range) following the primary diagnosis: 28 patients had epithelial malignancies, 6 melanomas, 6 lymphomas, 4 germinal cell carinomas, and 1 patient sarcoma.Results: In 45 patients, 90 mediastinal and hilar lymph nodes were punctured. In 6 lymph nodes no lymphocytes were detected (93.3% representative samples). Granulomatous reaction was found in 19 patients (42%), and in another 12 (27%), the lymph nodes were normal. In one patient, no lymphocytes and no malignant cells were present, and 24 months follow-up was uneventful. Metastases were seen in only 12 patients (27%), and in one patient a malignancy other than the primary tumor was detected. In 13 patients with colon cancer, the largest subgroup, metastases were found in 3.Conclusions: Cytopathological investigation of enlarged mediastinal or hilar lymph nodes in non-pulmonary malignancies is required to confirm the diagnosis, as the majority seem to be benign.