Endobronchial Ultrasound for the Diagnosis of Pulmonary Sarcoidosis

Garwood, Susan; Judson, Marc A.; Silvestri, Gerard A.; Hoda, Rana S.; Fraig, Mostafa; Doelken, Peter

doi:10.1378/chest.07-0998

Cited by 247 publications

(211 citation statements)

References 22 publications

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“…EBUS-TBNA was diagnostic in 85-91.8% of patients with a final diagnosis of sarcoidosis. The NPVs found in two of these studies [27,29] were 11% and 12.5%, respectively. In the investigation carried out by WONG et al [27], 21.6% of the patients (11 out of 51) demonstrated with EBUS-TBNA to have sarcoidosis revealed benign transbronchial lung biopsy results.…”

Section: Effectiveness In Other Pathologiesmentioning

confidence: 92%

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Effectiveness and safety of endobronchial ultrasound–transbronchial needle aspiration: a systematic review

2009

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The aim of the present systematic review was to assess the effectiveness and safety of real time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with suspected or known bronchopulmonary carcinoma, as well as in other clinical indications presented by lymphatic adenopathies.A systematic review was carried out in November 2007 and updated in April 2008 using the main databases. Inclusion and exclusion criteria were applied to the papers retrieved.A total of 20 publications were included. Of these, 14 were original studies that investigated the clinical usefulness of the technique in visualising and staging lymph nodes in patients with suspected or established lung cancer. Sensitivity ranged 85-100% and negative predictive value ranged 11-97.4%. Three studies assessed the clinical usefulness of the technique in the diagnosis of sarcoidosis. EBUS-TBNA was diagnostic in 88-93% of patients. One retrospective study evaluated the use of EBUS-TBNA in the diagnosis of lymphoma. None of the studies included in the present review reported important complications.Endobronchial ultrasound-guided transbronchial needle aspiration is a safe and highly accurate procedure for the examination and staging of mediastinal and hilar lymph nodes in patients with known or suspected lung malignancy. The evidence is promising for sarcoidosis but is not sufficient for lymphoma.

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Section: Effectiveness In Other Pathologiesmentioning

confidence: 92%

“…Three prospective studies considered in the present review assessed the usefulness of EBUS-TBNA in patients with suspicion of sarcoidosis [27][28][29] (table 2). The largest-scale study included 65 patients [27].…”

Section: Effectiveness In Other Pathologiesmentioning

confidence: 99%

Effectiveness and safety of endobronchial ultrasound–transbronchial needle aspiration: a systematic review

2009

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“…Additionally, numerous studies have reported the successful diagnosis of sarcoidosis by EBUS-TBNA (Garwood et al 2007;Tremblay and Stather, 2009). However, similar studies in patients with tuberculous lymphadenitis are limited (Navani et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis of Lymphoma

Şentürk¹,

Babaoğlu²,

Kılıç³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is highly accurate in diagnosing mediastinal lymphadenopathies of lung cancer and benign disorders. However, the utility of EBUS-TBNA in the diagnosis of mediastinal lymphomas is unclear. The aim of this study was to determine the diagnostic value of EBUS-TBNA in patients with suspected lymphoma. Materials and Methods: Sixty-eight patients with isolated mediastinal lymphadenopathy and suspected of lymphoma were included in the study. EBUS-TBNA was performed on outpatients under moderate sedation. The sensitivity, specificity, negative predictive value and diagnostic accuracy of EBUS-TBNA were calculated. Results: Sixty-four patients were diagnosed by EBUS-TBNA, but four patients with non-diagnostic EBUS-TBNA required surgical procedures. Thirty-five (51.5%) patients had sarcoidosis, six (8.8%) had reactive lymphadenopathy, nine (13.3%) had tuberculosis, one (1.5%) had squamous cell carcinoma, two (2.9%) had sarcoma and fifteen (22%) had lymphoma (follicular center cell, large B-cell primary, and Hodgkin lymphomas in three, two, and ten, respectively). Of the 15 lymphoma patients, thirteen were diagnosed by EBUS and two by thoracotomy and mediastinoscopy. The sensitivity, specificity, negative predictive value, and diagnostic accuracy of EBUS-TBNA for the diagnosis of lymphoma were calculated as 86.7%, 100%, 96.4%, and 97%, respectively. Conclusions: EBUS-TBNA can be employed in the diagnosis of mediastinal lymphoma, instead of more invasive surgical procedures.

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“…Endobronchial ultrasound-guided transbronchial needle aspirate (EBUS-TBNA) potentially fulfils all the requirements of an ideal diagnostic test in patients with suspected sarcoidosis. Single-centre studies have reported diagnostic yields of 83-94% and complication rates of ,1% [10,[13][14][15][16][17][18][19][20]. Recent studies concluded that EBUS-TBNA in combination with TBLB and other standard bronchoscopic techniques optimises the diagnostic yield and should be considered the first-line investigation in patients with suspected sarcoidosis [10,17,19].…”

Section: Introductionmentioning

confidence: 99%

“…Alternatively, the decision to proceed to TBLB after EBUS-TBNA was left up to the discretion of the bronchoscopist [13]. Rapid on-site evaluation (ROSE) of cytological material assists the EBUS-TBNA procedure by informing the bronchoscopist about the number of lymph node stations and passes that are required, and whether TBLB and EBB need to be undertaken at the same session rather than bringing the patient back when the final cytological or histological assessment has been completed [10,13,14,18]. This study is the first prospective, blinded study to assess the diagnostic accuracy and interobserver agreement between cytotechnologists of EBUS-TBNA with ROSE in patients with suspected sarcoidosis.…”

Section: Introductionmentioning

confidence: 99%

Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis

et al. 2012

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Rapid on-site evaluation (ROSE) of endobronchial ultrasound-guided transbronchial needle aspirates (EBUS-TBNA) has not been compared to final detailed cytological analysis in patients with suspected sarcoidosis.To assess the diagnostic accuracy of EBUS-TBNA with ROSE in patients with suspected sarcoidosis, a prospective two-centre study performed EBUS-TBNA with ROSE of cellular material followed by transbronchial lung biopsy (TBLB) and endobronchial biopsy (EBB). The diagnostic accuracy of EBUS-TBNA with ROSE was compared to the final cytological assessment and to TBLB and EBB.Analysis confirmed 49 out of 60 cases of sarcoidosis. ROSE sensitivity was 87.8% (specificity 91%, positive predictive value 97.7%). ROSE slide interpretation in combination with the final fixed slide and cell block preparations had a sensitivity of 91.8% (specificity 100%, positive predictive value 100%). 67% of patients were confirmed as having sarcoidosis on TBLB and 29% on EBB. Interobserver agreement between cytotechnologists and pathologists was very good (k50.91, 95% CI 0.80-1.0 and k50.91, 95% CI 0.79-1.0, respectively).EBUS-TBNA with ROSE has high diagnostic accuracy and interobserver agreement and informs the bronchoscopist in theatre whether additional diagnostic procedures need to be undertaken. EBUS-TBNA with ROSE should therefore be considered as the first-line investigation of sarcoidosis. @ERSpublications Rapid on-site evaluation of EBUS-TBNA should be first-line investigation in sarcoidosis

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Endobronchial Ultrasound for the Diagnosis of Pulmonary Sarcoidosis

Cited by 247 publications

References 22 publications

Effectiveness and safety of endobronchial ultrasound–transbronchial needle aspiration: a systematic review

Effectiveness and safety of endobronchial ultrasound–transbronchial needle aspiration: a systematic review

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis of Lymphoma

Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis

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