The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis of Mediastinal and Hilar Lymph Node Metastases in Patients with Extrapulmonary Malignancy

Song, Jae-Uk; Park, Hye Yun; Jeon, Kyeongman; Koh, Won‐Jung; Suh, Gee Young; Chung, Man Pyo; Kim, Hojoong; Kwon, O Jung; Um, Sang‐Won

doi:10.2169/internalmedicine.50.5834

Cited by 25 publications

(33 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, NPV was 88.3% in this study, which was similar to the results of other studies that reported rates of between 76% and 86.9% (17,19,27,28). Five cases were diagnosed as malignancy after mediastinoscopy, although EBUS-TBNA results were reported as benign.…”

Section: Discussionsupporting

confidence: 89%

“…A large study of 161 suspected metastases from extrapulmonary malignancy patients undergoing EBUS-TBNA demonstrated a sensitivity rate of 87% (20). Other studies also showed a sensitivity rate of 85%-96.3% (15)(16)(17)(18) (Table 4). In the present study, the sensitivity of EBUS-TBNA in suspected metastases from extrapulmonary malignancy patients was 78.2%, which is lower than in other studies.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy

Erer¹,

Anar²,

Erol³

et al. 2016

Turk J Med Sci

View full text Add to dashboard Cite

The aim of this study was to determine the diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal and hilar lymph nodes (LNs) in patients with known extrapulmonary malignancy. Materials and methods:Between March 2011 and August 2013, 378 EBUS-TBNA procedures were performed. Sixty-three (16.6%) of these were performed on known extrapulmonary malignancy patients.Results: There were 28 male and 35 female patients, with median ages of 65 years (min-max: 53-87) and 57 years (min-max: 39-76), respectively. From the 63 cases, 138 lymph nodes (LNs) were sampled with EBUS-TBNA (median: 2 LNs/patient; min-max: 1-4). Results of EBUS-TBNA revealed malignancy in 18 (28.5%) and nonmalignancy in 45 (71.5%). In the nonmalignant group, there were false negatives in 5 (7.9%), anthracosis in 13 (20.6%), reactive adenitis in 16 (25.3%), sarcoidosis in 7 (11.1%), and tuberculosis in 2 (3.1%), and 2 were not evaluated (lost to follow-up) (3.1%). The diagnostic sensitivity, accuracy, and negative predictive value of EBUS-TBNA per patient were 78.2%, 91.8%, and 88.3%, respectively. Conclusion:EBUS-TBNA is a safe, minimally invasive, and effective method and can be considered as the initial test for the histopathological diagnosis of mediastinal and hilar lymphadenopathy in patients with extrapulmonary malignancy.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 98%

The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy

Erer¹,

Anar²,

Erol³

et al. 2016

Turk J Med Sci

View full text Add to dashboard Cite

show abstract

“…The diagnostic yield of EBUS-TBNA in patients with intrathoracic lymphadenopathy and a history of an extrathoracic malignancy is reported to be in the mid-80% [7,25,26]. In our cohort, 80% (20/25) of the patients with a final diagnosis of metastatic intrathoracic lymphadenopathy were diagnosed by EBUS-TBNA alone.…”

Section: Discussionmentioning

confidence: 69%

Performance of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis of Isolated Mediastinal and Hilar Lymphadenopathy

Tyan¹,

Machuca²,

Czarnecka³

et al. 2017

Respiration

View full text Add to dashboard Cite

Background: Although many studies have assessed the diagnostic utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the context of a specific disease, few studies have assessed the overall diagnostic yield, sensitivity, and negative predictive value in patients with isolated mediastinal and hilar lymphadenopathy (IMHL). Objective: We evaluated the performance of EBUS-TBNA for diagnosing IMHL in a population with a high prevalence of concurrent or preexisting non-pulmonary malignancy. Methods: A retrospective chart review of patients who underwent EBUS-TBNA from October 2008 to April 2014 was performed to identify patients with IMHL. Patients with known or suspected primary pulmonary malignancy were excluded. When available, EBUS-TBNA results were cross-referenced with further diagnostic investigation or clinical diagnosis based on follow-up. Results: EBUS-TBNA was used to sample 765 lymph nodes from 350 patients. One hundred and fourteen (33.3%) patients had a concurrent or preexisting non-pulmonary malignancy. The overall yield of EBUS-TBNA for specific diagnosis was 300/350 (86%). The diagnostic yield for sarcoidosis, lymphoproliferative disease, metastatic lymphadenopathy from extrathoracic malignancy, and necrotizing granuloma was 123/149 (83%), 27/33 (82%), 20/25 (80%), and 13/19 (68%), respectively. Amongst 50 patients with non-diagnostic EBUS-TBNA, 25 yielded an insufficient sample and another 25 yielded only benign lymphoid material which was not representative of the underlying pathology. Overall, EBUS-TBNA had a sensitivity of 89%, a diagnostic yield of 86%, and a negative predictive value of 79%. Conclusion: For patients with isolated hilar or mediastinal lymphadenopathy and a high background prevalence of concurrent and preexisting non-pulmonary malignancy, EBUS-TBNA is a reliable first-line diagnostic investigation.

show abstract

“…Song et al [27] showed that a definitive diagnosis for the evaluation of nodal metastases from an extrapulmonary malignancy was achieved by EBUS-TBNA in 61.4% (n=35) of 57 patients, allowing them to avoid surgery. Furthermore, Parmaksız et al [28] evaluated mediastinal and hilar lymph nodes in 48 patients with a history of an extrathoracic malignancy and demonstrated that EBUS-TBNA could be used to accurately diagnose mediastinal lymph node metastases.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective analysis of 228 patients

Usluer¹

2015

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

ÖZAmaç: Bu çalışmada, malign ve benign hastalıklarda endobronşiyal ultrason rehberliğinde transbronşiyal iğne aspirasyonu (EBUS-TBİA) işleminin tanısal değeri araştırıldı. Ça lış ma pla nı: Nisan 2011 -Ocak 2013 tarihleri arasında EBUS-TBİA uygulanan 228 hasta (165 erkek, 63 kadın; ort. yaş 58.1 yıl; dağılım 22-84 yıl) retrospektif olarak incelendi. Tüm hastalara midazolam sedasyonu uygulandı. Lenf nodlarından alınan örneklerin tanısal doğrulaması cerrahi girişim veya klinik ve radyolojik takip ile yapıldı. Bul gu lar: Toplam 228 EBUS-TBİA işleminde 635 lenf noduna (her hasta için ortalama 2.78, dağılım 1-6) 1447 aspirasyon (her hasta için ortalama 6.47, dağılım 1-12) uygulandı. Hastaların %98.6'sında (225/228) örnekler histopatolojik olarak uygun idi. Histopatolojik incelemede 88 reaktif hiperplazi (%39), 82 neoplastik hastalık (%36), 39 granülomatöz hastalık (%17) (dört hasta tüberküloz ile uyumlu) ve malign hastalıktan şüphelenilen beş hasta (%2) saptandı. Hassasiyet, özgüllük, pozitif öngörü değeri, negatif öngörü değeri ve doğruluk oranları sırasıyla %91.7, %100, %100, %88.9 ve %95 idi. EBUS-TBİA işlemine bağlı mortalite gözlenmedi. So nuç: Bu çalışma mediastinal ve hiler lenf nodlarının değerlendirilmesinde EBUS-TBİA'nın güvenli ve tanısal değeri yüksek bir yöntem olduğuna işaret etmektedir. ABSTRACTBackground:This study aims to investigate the diagnostic value of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) procedure in malign and benign diseases. Methods: Two hundred twenty-eight patients (165 males, 63 females; mean age 58.1 years; range 22 to 84 years) who were performed EBUS-TBNA between April 2011 and January 2013 were retrospectively analyzed. Midazolam sedation was applied in all patients. The diagnostic verification of the samples collected from lymph nodes was carried out by surgical intervention or clinical and radiological follow-up. Results:In a total of 228 EBUS-TBNA procedures, 1,447 aspirations (average 6.47 for each patient, range 1-12) were applied to 635 lymph nodes (average 2.78 for each patient, range 1-6). In 98.6% of the patients (225/228), the samples were histopathologically appropriate. The histopathological examination identified 88 reactive hyperplasias (39%), 82 neoplastic diseases (36%), 39 granulomatous diseases (17%) (tuberculosis compatible in four patients), and five patients with suspicion of malignant diseases (2%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 91.7%, 100%, 100%, 88.9%, and 95%, respectively. No mortality was observed associated with EBUS-TBNA procedure. Conclusion: This study suggests that EBUS-TBNA is a reliable method with high diagnostic value in the evaluation of the mediastinal and hilar lymph nodes.

show abstract

The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis of Mediastinal and Hilar Lymph Node Metastases in Patients with Extrapulmonary Malignancy

Cited by 25 publications

References 25 publications

The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy

The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy

Performance of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis of Isolated Mediastinal and Hilar Lymphadenopathy

Endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective analysis of 228 patients

Contact Info

Product

Resources

About