Flexible Bronchoscopy in the Evaluation of Mediastinal and Hilar Lymphadenopathy

Rai, Santosh; Bhattacharyya, Dipak Kumar; Choudhary, RK

doi:10.1016/s0377-1237(07)80101-8

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…The neoplastic causes include lymphoma, leukaemia and metastatic carcinoma. Sarcoidosis is also a common cause of intra thoracic lymphadenopathy [2].…”

Section: Discussionmentioning

confidence: 99%

“…Also Rai et al [2] mentioned that bronchoscopy showed abnormality in 39.6% of patients with mediastinal lymphadenopathy and these abnormalities included widening of main carina in 12.5%, widening of secondary carina in 8.3%, bulge into airways because of extrinsic compression in 14.6% and endobronchial nodule in 4.2% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…There are many causes of mediastinal and hilar lymphadenopathy, including infection, neoplasm, granulomatous disease and reactive hyperplasia. Chest radiographs and computed tomography (CT) have become the standard technique for demonstration of mediastinal and hilar lymphadenopathy and in many cases biopsy is required to establish the specific diagnosis [2].…”

Section: Introductionmentioning

confidence: 99%

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Anatomical and histopathological airway abnormalities detected during fiberoptic bronchoscopy in patients with mediastinal lymphadenopathy

Eid

Khatab

Ahmed

et al. 2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Background: The diagnosis in cases of mediastinal and hilar lymphadenitis without parenchymal involvement of the lung is often difficult. Mediastinal lymphadenopathy may be due to a variety of benign or malignant reasons. Hence, it is important to establish a diagnosis and differentiate benign from malignant lymph nodes.Aim of the work: To study the usefulness of fiberoptic bronchoscopy in diagnosis of patients with mediastinal lymphadenopathy.Patients and methods: The present study included 30 patients with mediastinal lymphadenopathy. All were subjected to written informed consent, full history taking, full clinical examination, tuberculin skin test, chest X-ray and CT chest. Fiberoptic bronchoscopy including autofluorescence bronchoscopy with mucosal biopsies, TBNA and bronchial lavage were also obtained.Results: 46.7% of the study patients were diagnosed as malignancy, 20% diagnosed as sarcoidosis, 10% diagnosed as TB, 3.33% diagnosed as reactive lymphadenitis and 20% were undiagnosed. Observed anatomical airway abnormalities included vocal cord paralysis (16.7%), tracheal compression (3.3%), widening of main or second carina (80%) and mucosal abnormalities (46.7%) in the form of nodules, infiltration with tumour tissue and unhealthy mucosa. Bronchial mucosal biopsy was the most useful method of diagnosis (56.7%) followed by TBNA (30%) and finally BAL (13.3%). AFB has no cost effective value over WLB in detection of malignant lesions.

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“…The neoplastic causes include lymphoma, leukaemia and metastatic carcinoma. Sarcoidosis is also a common cause of intra thoracic lymphadenopathy [2].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Anatomical and histopathological airway abnormalities detected during fiberoptic bronchoscopy in patients with mediastinal lymphadenopathy

Eid

Khatab

Ahmed

et al. 2015

Egyptian Journal of Chest Diseases and Tuberculosis

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“…While metastatic cancer, lymphoma and sarcoidosis are more common causes of lymphadenopathy in the developed world, infective and benign aetiologies are more likely in the developing world like India. 1,2 Mediastinal lymphadenopathy requires accurate diagnosis to determine the optimal treatment. For this nodal sampling is necessary that has traditionally been done by CT-guided fine needle aspiration cytology (FNAC) and/or biopsy, mediastinoscopy, and/or thoracoscopy.…”

Section: Introductionmentioning

confidence: 99%

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Under Local Anesthesia: Real-time Experience Over Two Years in a Tertiary Care Hospital in North India

Spalgais¹,

Kumar²,

Mrigpuri³

et al. 2022

The Indian Journal of Chest Diseases and Allied Sciences

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Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUs-tBNA) is usually performed under deep sedation or conscious sedation. We describe the diagnostic yield and complications of EBUs-tBNA performed under local anesthesia.Methods. patients undergoing EBUs-tBNA at our center from February 2016 to April 2018 were evaluated retrospectively. All procedures performed under local anesthesia using lignocaine were assessed for sampling adequacy, diagnostic yield, cough during endoscopic procedure and complications.results. thirty-four patients underwent EBUs-tBNA under local anesthesia. Mean age was 41.1 years with male to female ratio of 1:1. Mean (standard deviation) dose of lignocaine used was 311.6 (16.4) milligram and mean (standard deviation) duration of the procedure was 23.7 (3.78) minutes. sample adequacy rate was 88.2%. the diagnostic yield of the procedure was 60%. In 91.1% of patients, cough was absent or did not interfere with EBUs-tBNA. complications related to EBUs were observed in three (8.8%) patients and were minor and self-limiting. None of the patients required escalation of care. conclusion. EBUs-tBNA performed under local anesthesia was found to be safe and was associated with an acceptable diagnostic yield. [indian j chest dis allied sci 2020;62: [19][20][21][22]

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Diagnostic utility of flexible bronchoscopy in mediastinal and hilar lymphadenopathies

Farag

2019

The Scientific Journal of Al-Azhar Medical Faculty, Girls

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Background Mediastinal and/or hilar lymphadenopathy with or without parenchymal lesions are difficult in the diagnosis via noninvasive techniques. Objective To assess the role of flexible fiberoptic bronchoscopy (FOB), in particular, blind transbronchial needle aspiration (TBNA) in the diagnosis of mediastinal and/or hilar lymphadenopathies. Patients and methods A cross-sectional study was carried out on 42 out of 83 patients presented by chest radiography of hilar and/or mediastinal lymphadenopathies with or without parenchymal lesions. Contrast-enhanced computed tomography chest and FOB, TBNA, and bronchoalveolar lavage were done for all patients. Forceps biopsy and bronchial brushing were done for some patients with bronchoscopic airway abnormalities. Results A total of 52 patients underwent FOB procedures; among them 10 (19.2%) patients were excluded due to nonconclusive diagnosis for further evaluations; final histopathological and/or microbiological diagnosis was confirmed in 42 (80.8%) patients, and they were included in data analysis. Among them, 25 (59.5%) patients had malignant lymphadenopathies (five patients had small cell lung cancer, 18 patients had nonsmall cell lung cancer, and two patients had lymphoma) and 17 (40.5%) had benign lymphadenopathies (eight patients had sarcoidosis, three patients had tuberculosis, six patients had reactive lymphadenitis). The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of TBNA in the diagnosis of intrathoracic lymphadenopathies were 75.00, 54.50, 60.00, 70.60, and 64.29%, respectively. Conclusion Bronchoscopy with TBNA has good sensitivity and negative predictive value with fair specificity and positive predictive value in the diagnosis of intrathoracic lymphadenopathies. TBNA is a safe, effective procedure and can be performed easily during routine diagnostic bronchoscopy, and minimize the requirement for mediastinoscopy and thoracotomy.

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Flexible Bronchoscopy in the Evaluation of Mediastinal and Hilar Lymphadenopathy

Cited by 3 publications

References 15 publications

Anatomical and histopathological airway abnormalities detected during fiberoptic bronchoscopy in patients with mediastinal lymphadenopathy

Anatomical and histopathological airway abnormalities detected during fiberoptic bronchoscopy in patients with mediastinal lymphadenopathy

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Under Local Anesthesia: Real-time Experience Over Two Years in a Tertiary Care Hospital in North India

Diagnostic utility of flexible bronchoscopy in mediastinal and hilar lymphadenopathies

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