Abstract
Introduction
The utility of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) in the diagnosis of lymphoproliferative disorders (LPD) is not well established. This is a minimally invasive technique that allows obtaining samples of mediastinal lymph nodes (MLN) for pathologic and flow citometry analysis, useful for the diagnosis of LPD.
Objective: Evaluate the utility of EBUS-TBNA in the diagnosis of LPD in patients with lymph nodes/mediastinal masses and clinical suspicion of LPD.
Methods: Retrospective analysis of patients with MLN and suspected LPD that performed EBUS-TBNA between 2009 and 2012.
Results: 189 patients underwent EBUS-TBNA to investigate MLN. 6.9% (13) had clinical suspicion of LPD. 61.5% male, mean age 58.4±15.9 years. Results were: LPD (3), granulomatous disease (2), reactive lymph node (4) and inadequate sample (4). Among patients with inconclusive results (8), in 25% (2) LPD was confirmed by other methods (thoracotomy or EBUS-TBNA repetition). The diagnosis of reactive lymph node was confirmed in three patients with clinical and radiological monitoring, and in three patients MLN were not investigated by other method. One patient of the last group had the diagnosis of LPD by peripheral lymph node biopsy.
In the study, the diagnosis of LPD has been established in five. The sensitivity, negative predictive value and diagnostic accuracy of EBUS-TBNA in the diagnosis of LPD were 60, 71.4 and 61.5%, respectively.
Conclusion
EBUS-TBNA is a useful method for the investigation of patients with MLN with suspected LPD that can reduce the need for more invasive exams. Thus, it may be considered in the initial evaluation of these patients.
- © 2014 ERS