Characteristics of false-negative cases

False-negative statusComment
Presumed2R (22-mm long axis) sampled after EBUS TBNA 4R (13 mm), 4 L (13 mm), all samples reported as “atypical cells”. All nodes were PET-avid. Metastatic carcinoma (no subtype possible) diagnosed from fine-needle aspirate of PET-avid right supraclavicular node (15 mm).
ConfirmedPET-avid 2R (20 mm) sampled; sample contained lymphocytes, lymphoma eventually diagnosed on mediastinoscopy.
PresumedStation 7 sampled, lymphocytes only, lost to follow-up, so assigned false negative.
ConfirmedPET-avid stations 7 (25 mm) and 2R (18 mm) sampled for mediastinal lymphadenopathy in the context of prior colorectal cancer. Non-necrotising granulomatous inflammation on cytology, Hodgkin's lymphoma diagnosed on cervical lymph node excisional biopsy (20 mm).
ConfirmedStation 7 sampled and lymphocytes only reported; resection demonstrated a 0.5 mm focus of metastatic disease.

EBUS TBNA: endobronchial ultrasound transbronchial needle aspirate; PET: 18F-fluorodeoxyglucose positron emission tomography.