Abstract
Background: Transbronchial needle aspiration with endobronchial ultrasound (EBUS) is an accurate and safe tool for diagnostic sampling of mediastinal lymph nodes and is considered the optimum test for thoracic nodal evaluation. Even so, patients with negative EBUS biopsies are often assessed by mediastinoscopy in an effort to augment diagnostic yield.
Objective: We evaluated the added value of mediastinoscopy after nondiagnostic EBUS in our institution.
Methodology: Records from patients that underwent mediastinoscopy over a 5 year period were reviewed. Those with a prior nondiagnostic EBUS were included in the study. Patients were divided in two groups according to the clinical suspicion of lung cancer prior to EBUS. The added diagnostic value provided by mediastinoscopy was assessed according to lymph node pathology results.
Result: A total of 56 patients underwent mediastinoscopy after nondiagnostic EBUS. Mediastinoscopy yielded additional diagnostic information in 3 of the 32 patients (9.3%) in the group with high clinical suspicion of lung cancer and 11 of 24 patients (45.3%) in the group with low clinical suspicion of lung cancer. The overall negative predictive value (NPV) of EBUS among the entire cohort that underwent mediastinoscopy post non diagnostic EBUS were 75% and was 90.6% in high suspicion for lung cancer group.
Conclusions: Thoracic lymph node sampling by EBUS had a high NPV among patients with suspected lung cancer group. However, where clinical concern of malignancy remains after negative EBUS-TBNA, mediastinoscopy should be considered.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 2859.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020
