RT Journal Article
SR Electronic
T1 EBUS-TBNA in patients with extra-pulmonary malignancies with thoracic lymphadenopathy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA4766
DO 10.1183/13993003.congress-2019.PA4766
VO 54
IS suppl 63
A1 Ajay Ravi
A1 Dhammdeep Kadam
A1 Rajiv Goyal
A1 Jeenam Shah
A1 Sagar Raiya
A1 Abhijit Ahuja
A1 Anurag Deshpande
A1 Ujjwal Sharma
YR 2019
UL http://erj.ersjournals.com/content/54/suppl_63/PA4766.abstract
AB Background: Thoracic lymphadenopathy, in extra pulmonary malignancies(EPM) need not always represent a malignant process, the knowledge of which is of prime therapeutic and prognostic implications. Positive imaging can also be due to benign causes, and therefore a minimally invasive, tissue diagnosis is required.Aims and Objectives: To determine the role of EBUS TBNA in diagnosis of PET positive/enlarged mediastinal lymph nodes(LNs)in patients with a known EPM.Methods: Retrospective study on 40 patients with proven EPM and with PET active LN(SUV>2.5) or short-axis diameter>1cm on CT, who underwent EBUS-TBNA with Rapid on-site evaluation(ROSE). Pathological examination was done in all and mycobacterial tests done where indicated. Clinical and radiological follow-up done in patients with benign nodes for at least 6 months.Results: Nodes were positive for malignancy in 18(45%) and benign in 22(55%). 13(32.5%)had reactive LN, 6(15%) had non specific granulomatous LN and 3(7.5%) had TB LN. One among those negative, who had LN enlargement on follow up, was found to be positive for malignancy by CT guided FNA. All 3 patients with TB lymphadenitis responded to treatment. 2 patients with reactive LN were lost to followup, while all the rest were stable. EBUS-TBNA sensitivity-94.7%, specificity-100%, positive predictive value-100%, negative predictive value-95.45%, overall diagnostic accuracy-97.5% and complications-0%Conclusions: More than half of patients with EPM, despite having PET /CT positive thoracic nodes, were diagnosed to have benign adenopathy with EBUS TBNA, which makes it a safe, minimally invasive, accurate and essential tool for diagnosing thoracic lymphadenopathy in these patients.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA4766.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).