Abstract
AIM:The aim of our study was to evaluate the contribution of EBUS-TBNA for diagnosing mediastinal metastases in patients with extrathoracic malignancy that underwent EBUS-TBNA for intrathoracic lymphadenopathy.
PATIENTS & METHODS:We retrospectively reviewed all patients with a concurrent or a previous diagnosis of extrathoracic malignancy who where referred for EBUS-TBNA for clinical suspicion for mediastinal and/or hilar nodal metastases.In cases where EBUS-TBNA findings were positive for malignancy they were assumed to be true-positives and no tissue confirmation was requested.Patients to whom results were not malignant and no other benign alternative diagnoses was established underwent surgical confirmation or follow-up.
RESULTS: of 117 patients,51(43.5%)cases EBUS-TBNA revealed metastatic extrathoracic malignancy,27(23%)cases a primary thoracic malignancy and in 4(3.4%)patients a benign diagnosis.In 35 were found normal lymph node,14(11.9%)underwent surgery.Other 21(17.9%)patients who had normal lymph node underwent clinical and radiological follow-up:13(11.1%)confirmed stable or regressive lymphadenopathy and 8(6.8%)patients developed radiological progression and were assumed to be false negative. The sensitivity and negative predictive value(NPV)for diagnosing thoracic nodal metastases from extrathoracic malignancy was 86.4% and 77.1% respectively.The overall accuracy was 86.3%.
CONCLUSION: EBUS-TBNA is an accurate method for the diagnosis of thoracic nodal metastases from extrathoracic malignancy with a sensibility of 86.4%,a NPV of 77.1% and an overall accuracy of 86.3%.
- © 2012 ERS
