RT Journal Article
SR Electronic
T1 Normal lymph node size at Endobronchial ultrasound guided Transbronchial needle aspiration correlates to benign cytopathological diagnosis but does not rule out malignancy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2813
DO 10.1183/13993003.congress-2016.PA2813
VO 48
IS suppl 60
A1 Ida Skovgaard Christiansen
A1 Uffe Bødtger
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA2813.abstract
AB Introduction: Mediastinal lymph node (LN) short axis diameter of >10 mm at CT scan is the radiological cut-off for abnormality. LN size is one of several ultrasonographical estimates performed during endobronchial ultrasound guided (EBUS).Objective: To evaluate if EBUS measured LN size was associated with benign cytology, adequacy of sampling or procedure-related features.Method: Consecutive patients undergoing EBUS TBNA for suspected malignancy in our unit Sep/13 – Feb/14. We recorded LN variables (size, border, heterogeneity, hilus), needle passes, LN contact, aspired blood, clot formation, smear (number, visible cell rich aspirate, anthracosis). Cytopathological diagnosis for each LN sample was considered Adequate or Inadequate (lymphatic tissue present resp. not present). Diagnosis of adequate samples was either benign, malignant, non-necrotic granuloma (sarcoidosis).Results: Totally 640 samples were obtained during 219 EBUS procedures. Size was noted in 632 (≤10 mm: n=355; 56%) samples, and of these 558 (88%) were adequate.LN diagnoses were benign/malignant /sarcoidosis in 339(61%)/184(33%)/35(6%).Size ≤10 mm was significantly associated to benign result, yet 15% was malignant. Conversely, 86 (34%) of enlarged LNs were benign.Size ≤10 mm was negatively associated with adequate sampling and formation of cell blocks, and positively associated with antracosis.Conclusions: Using the traditional cut-off of ≤10 mm for normal mediastinal LN size during EBUS does not accurately predict cytopathological outcome in a population referred for mediastinal workup for suspected malignancy.