The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience

Natu, S; Hoffman, Joanne; Siddiqui, Momin T.; Hobday, Catherine; Shrimankar, Jyotsna; Harrison, Richard

doi:10.1136/jcp.2009.074328

Cited by 40 publications

(33 citation statements)

References 10 publications

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“…LBC has progressively gained favor after being applied in fine-needle aspiration cytology. A few studies applied LBC to EBUS-TBNA aspirates because LBC reduced the number of slides and saved time [17,18]. Our study demonstrated that LBC can improve the diagnostic value of EBUS-TBNA cytological assessment.…”

Section: Discussionmentioning

confidence: 54%

Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

et al. 2015

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Objective: This study investigated whether liquid-based cytology (LBC) can improve diagnostic values of cytological assessment of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Study Design: A cohort of 600 cases in West China Hospital was prospectively studied from June 2012 to September 2013. EBUS-TBNA was carried out in outpatients under local anesthesia and moderate sedation. The procedure was performed with an echobronchoscope (BF-UC160F-OL8, Olympus, Tokyo, Japan). Histological cores were stained with hematoxylin and eosin for further study. Additional immunohistological analysis was performed for establishing a reliable diagnosis when necessary. Aspirates were smeared on glass slides and separate aspirates were processed by the monolayer SurePath method. Results: In total, 480 malignant tumors and 120 benign lesions were confirmed by histological examination. The sensitivity of SurePath liquid-based preparations and conventional smears was 82.1 and 56%, and the specificity was 87.5 and 82.5%, respectively. The combined specificity was 100%. Positive predictive values of the two groups were 96.3 and 92.8%, whereas negative predictive values were 54.9 and 31.9%, respectively. The difference between the two groups was significant (p < 0.001). Conclusions: LBC preparation can improve cytological assessment of EBUS-TBNA. Histological study is necessary in cases in which the cytological diagnosis is obscure.

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Section: Discussionmentioning

confidence: 54%

Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

et al. 2015

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“…However, both techniques have been shown valuable for histologic diagnosis [33,34,35,36,37,38,39,40,41,42]. …”

Section: Results Of Pico Questionmentioning

confidence: 99%

Guideline for the Acquisition and Preparation of Conventional and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Specimens for the Diagnosis and Molecular Testing of Patients with Known or Suspected Lung Cancer

et al. 2014

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Rationale: Conventional transbronchial needle aspiration (TBNA) and endobronchial ultrasound (EBUS)-TBNA are widely accepted tools for the diagnosis and staging of lung cancer and the initial procedure of choice for staging. Obtaining adequate specimens is key to provide a specific histologic and molecular diagnosis of lung cancer. Objectives: To develop practice guidelines on the acquisition and preparation of conventional TBNA and EBUS-TBNA specimens for the diagnosis and molecular testing of (suspected) lung cancer. We hope to improve the global unification of procedure standards, maximize the yield and identify areas for research. Methods: Systematic electronic database searches were conducted to identify relevant studies for inclusion in the guideline [PubMed and the Cochrane Library (including the Cochrane Database of Systematic Reviews)]. Main Results: The number of needle aspirations with both conventional TBNA and EBUS-TBNA was found to impact the diagnostic yield, with at least 3 passes needed for optimal performance. Neither needle gauge nor the use of miniforceps, the use of suction or the type of sedation/anesthesia has been found to improve the diagnostic yield for lung cancer. The use of rapid on-site cytology examination does not increase the diagnostic yield. Molecular analysis (i.e. EGFR, KRAS and ALK) can be routinely performed on the majority of cytological samples obtained by EBUS-TBNA and conventional TBNA. There does not appear to be a superior method for specimen preparation (i.e. slide staining, cell blocks or core tissue). It is likely that optimal specimen preparation may vary between institutions depending on the expertise of pathology colleagues.

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“…Despite all these, a tissue biopsy should be performed as soon as possible to reach a final diagnosis. EBUS-TBNA is a reliable technique for the investigation of unexplained mediastinal lymphadenopathy and staging of lung cancers (5). EBUS-TBNA is preferred over transbronchial biopsy (TBB) for sampling mediastinal lymph nodes (6).…”

Section: Discussionmentioning

confidence: 99%

Erlotinib Treatment in a Case of Lung Adenocarcinoma Mimicking Interstitial Lung Disease

Yılmaz¹,

Ak²,

Metintaş³

2017

Eurasian J Pulmonol

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Lung adenocarcinoma (LA) may occur with a radiographic appearance of localized tumor in the parenchyma or with diffuse parenchymal infiltration as interstitial lung disease (ILD). In our country, erlotinib is a tyrosine kinase inhibitor used in Epidermal Growth Factor Receptor (EGFR) mutation-positive patients who are resistant to first-line chemotherapy. A 48-year-old patient presented to our hospital with weakness and shortness of breath on exertion. Mediastinal enlargement and bilateral multinodules were observed in the chest X-ray. Ordinary blood laboratory values and arterial blood-gas analysis findings were normal. Lung function tests showed moderate restrictive ventilation and reduction of diffusing capacity based on the predicted value. A thorax computed tomography scan showed multiple mediastinal lymphadenopathies and bilateral diffuse perilymphatic nodule spread. The patient diagnosed with LA on the basis of endo-bronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Because of bilateral diffuse involvement of the lung, platinum-based combination chemotherapy was recommended. The progression of disease had occurred after two cycles, and a second-line treatment with erlotinib (150 mg/day) was initiated. A decrease in all lesions was observed in patient follow-up. The treatment with erlotinib was well tolerated. There was no adverse event for 6 months. This case was presented for the choice of LA that mimicked ILD and for the significant clinical and radiological responses to erlotinib in patients with EGFR mutation.

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The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience

Abstract: EBUS guided TBNA, in our experience, is a reliable technique for staging of lung cancers, and investigation of unexplained mediastinal lymphadenopathy and masses. LBC reduces the number of slides from 7.5 per case to 1 slide, reducing time required for diagnosis.

Cited by 40 publications

References 10 publications

Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Guideline for the Acquisition and Preparation of Conventional and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Specimens for the Diagnosis and Molecular Testing of Patients with Known or Suspected Lung Cancer

Erlotinib Treatment in a Case of Lung Adenocarcinoma Mimicking Interstitial Lung Disease

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