RT Journal Article
SR Electronic
T1 Endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal staging of extrathoracic neoplasm
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3727
VO 44
IS Suppl 58
A1 Vanessa Santos
A1 Maria Sucena
A1 Adriana Magalhães
A1 Gabriela Fernandes
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3727.abstract
AB IntroductionThe presence of mediastinal lymph node metastasis (MLNM) in patients with extrathoracic malignancy (ETM) has prognostic and therapeutic consequences, implying pathological confirmation of malignancy. Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) can be useful in this setting.Objectives: Evaluate the utility of EBUS-TBNA in the diagnosis of MLNM in patients with ETM.Methods: Retrospective analysis of patients with ETM with enlarged intrathoracic lymph nodes (LN), referenced to perform EBUS-TBNA between 2009 and 2012.Results: 189 patients underwent EBUS-TBNA to investigate mediastinal LN. 14.8% (28) had clinical suspicion of ETM's metastasis. 60.7% male, mean age of 58.2±16.3years. 19 had history of malignancy: colorectal (8), kidney (5), breast (3), oesophagus (3), ovarian (2), skin (2), thyroid (1), prostate (1), testicular (1) and metastasis of unknown tumor (2). Histological diagnosis of ETM was under investigation in 9 patients. Results were: metastasis of ETM (10), reactive LN (13), nodal involvement of lung tumor(1), granulomatous disease (2) and non-representative sample (2). Among 13 patients with reactive LN and 2 non-representative samples, 2 MLNM were confirmed by another EBUS-TBNA procedure/clinical surveillance (false negatives), 11 patients were confirmed by clinical/radiological surveillance (true negatives) and in 2 the diagnosis wasn't confirmed. Sensitivity, negative predictive value and diagnostic accuracy in the diagnosis of MLNM were 83.3, 87.5 and 85.7%, respectively.ConclusionEBUS-TBNA is an effective procedure in the diagnosis of MLNM in patients with ETM and should be included in their evaluation.