PT  - JOURNAL ARTICLE
AU  - Su Ying Low
AU  - Mariko S.Y. Koh
AU  - Thun-How Ong
AU  - Ghee-Chee Phua
AU  - Devanand Anantham
TI  - EBUS-TBNA for diagnosis of granulomatous mediastinal lymphadenopathy
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P3595
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P3595.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P3595.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Methods: Retrospective review of all patients who underwent EBUS-TBNA for suspected granulomatous mediastinal lymphadenopathy at Singapore General Hospital between 2008 and 2011.Results: Over 3 years 33/371(9%)patients underwent EBUS-TBNA for suspected granulomatous mediastinal lymphadenopathy – 18 for tuberculous(TB) and non-tuberculous mycobacterial(NTM) lymphadenitis, 15 for sarcoidosis. Mean age 47±18 years, 54.5% male. Total of 49 lymph node stations were sampled, with station 7 the most frequent (43%). Median size of lymph node was 17mm(8-30), median number of passes per lymph node 2(1-5), and core biopsy obtained in 45(92%). Median follow-up was 9months(0.5-26).13/18 patients had TB/NTM and EBUS-TBNA was diagnostic in 9. EBUS-TBNA cultures were positive in 6(67%), 1 showed acid-fast bacilli but cultures were negative, 2 had necrotizing granulomatous inflammation from biopsies and sputum cultures grew TB. Of the 4 false negatives, mediastinoscopy in 1 patient found NTM, 1 patient's bronchial washings grew TB, and 2 patients responded to TB treatment.14/15 patients had sarcoidosis and EBUS-TBNA was diagnostic in 9 with non-caseating granulomatous inflammation on histology. Of the 5 false negatives, 1 patient had a transbronchial lung biopsy consistent with sarcoidosis, the other 4 were diagnosed based on clinical history, response to treatment and follow-up.Sensitivities of EBUS-TBNA for TB/NTM, sarcoidosis and overall granulomatous mediastinal lymphadenopathy were 69%, 64%, 64%, NPV were 56%, 17%, 33%, and accuracies were 78%, 67%, 70% respectively.Conclusion: EBUS-TBNA can be useful in the diagnosis of suspected granulomatous mediastinal lymphadenopathy with a sensitivity and accuracy of >60%.