Thoracic lymphadenopathy in Asians resident in the United Kingdom: role of mediastinoscopy in initial diagnosis.

Farrow, Pr; Jones, D A; Stanley, Philip; Bailey, Jonathan; Wales, J. M.; Cookson, John

doi:10.1136/thx.40.2.121

Cited by 22 publications

(21 citation statements)

References 13 publications

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“…Its immediate emergence and rapid disappearance suggest that acid-fast mycobacteria and blood had escaped from the lymph nodes and been aspirated into the peripheral airway for a couple of days. Usually, tuberculous lymph nodes do not contain a large amount of acid-fast mycobacteria, resulting in the low positive rate of microbiological examinations, which has been reported to be approximately 20-30% of positive smears and 40-50% of positive cultures (3)(4)(5)(6)(7)(8). The sputum smears were negative throughout the patient's clinical course in Case 1, both before and after EBUS-TBNA.…”

Section: Discussionmentioning

confidence: 92%

“…Navani and colleagues (1) reported excellent results using EBUS-TBNA in patients with intrathoracic tuberculous lymphadenopathy; the procedure was diagnostic in 94% of cases, with a positive smear in 17% of the patients, positive cultures in 47% of the patients and pathological findings consistent with tuberculosis in 86% of the patients. Whereas the diagnostic success rate is very similar to that achieved with mediastinoscopy or conventional TBNA (3)(4)(5)(6)(7)(8), EBUS guidance allows for the safe aspiration of the hilar nodes and nodes measuring <10 mm in size (1) and increases the proportion of patients that can be diagnosed using this technique. EBUS-TBNA has been concluded to be safe and effective, with just one complication in 156 consecutive patients.…”

Section: Introductionmentioning

confidence: 77%

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EBUS-TBNA-related Complications in a Patient with Tuberculous Lymphadenopathy

et al. 2013

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Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is becoming more common for diagnosing intrathoracic lymphadenopathy, including tuberculous lymphadenopathy. We herein report two cases of complications possibly related to EBUS-TBNA for tuberculous lymphadenopathy. The first patient was a 26-year-old woman who developed intrabronchial polypoid granulomas exclusively at puncture sites two months after undergoing EBUS-TBNA. Although endobronchial extension may occur, the risk of aggravation caused by puncture should be considered. The second patient was a 39-year-old woman with transient smear-positive bloody sputum that developed immediately after EBUS-TBNA and persisted for three days. Temporary isolation following EBUS-TBNA should be considered for possible tuberculous lymphadenopathy.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 77%

EBUS-TBNA-related Complications in a Patient with Tuberculous Lymphadenopathy

et al. 2013

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“…Anterior mediastinoscopy or thoracotomy may be required to establish their diagnosis [3]. Farrow et al obtained 14/24 culture positivity by mediastinoscopy [16].…”

Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing intrathoracic tuberculous lymphadenitis.

et al. 2015

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Aims: Patients with suspected tuberculosis without pulmonary lesions and with intrathoracic lymphadenopathy often pose a diagnostic challenge. The aim of this study was to describe the diagnostic utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with isolated intrathoracic lymphadenopathy due to tuberculosis (TB). Materials and methods: Cases with tuberculous lymphadenitis (TBLA) as the final diagnosis were analysed among patients in whom EBUS-TBNA had been performed. All patients underwent routine clinical assessment and a CT scan prior to EBUS-TBNA. Demographic data, pathological findings, and microbiological results were recorded. All patients received 6-month antituberculous treatment, followed-up regularly and recovered both on clinical and radiological basis. Results: Fourty-four patients were included. EBUS-TBNA diagnosed TB intrathoracic lympadenopathy in 42 (95.4%) patients. In 2 patients, EBUS-TBNA was not able to confirm a diagnosis and additional procedures were required. Cytopathological findings alone revealed TB in 32 (72.7%) patients. One of the patients (2.2%) was smear positive while microbiological investigations provided a positive culture of TB in 22 (50%) patients. TB culture was positive in 10 of 12 patients in whom cytopathologic evaluation was not able to diagnose. Addition of mycobacterium culture to cytopathologic investigation has improved the diagnostic yield from 72.7% to 95.4%. Conclusion: EBUS-TBNA is a safe and effective first line investigation for evaluating isolated intrathoracic tuberculous lympadenopathy. Addition of mycobacterium culture to cytopathologic investigation improves the sensitivity of EBUS-TBNA.

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“…Bilateral hilar lymphadenopathy is usually due to either sarcoidosis or lymphoma, while bilateral tu berculous adenopathy is reportedly uncommon [3]. Far row et al [4] have described 6 patients with bilateral hilar lymphadenopathy in 34 tuberculous thoracic lymphadenopathies. Kent et al [5] reported 19 of 30 patients with clin ical, radiologic and histologic features of sarcoidosis, who on further evaluation demonstrated evidence of tubercu losis.…”

Section: Discussionmentioning

confidence: 99%

A Case of Pulmonary Tuberculosis with Bilateral Hilar Lymphadenopathy Diagnosed by Sputum Culture Subsequent to Open Thoracic Biopsy

Miyagawa

Mitsuyama²,

Hayashi³

et al. 1992

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We report a case of pulmonary tuberculosis with bilateral hilar lymphadenopathy. Open thoracic lymph nodes and lung biopsy revealed findings consistent with sarcoidosis. Culture and special staining of the biopsied specimen for mycobacteria were negative. Culture of the postoperative sputum grew Mycobacterium tuberculosis and antituberculous therapy resulted in a decrease in sizes of the lymphadenopathy. A review of the literature, with emphasis on the differential diagnosis between tuberculosis and sarcoidosis, is discussed.

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Thoracic lymphadenopathy in Asians resident in the United Kingdom: role of mediastinoscopy in initial diagnosis.

Cited by 22 publications

References 13 publications

EBUS-TBNA-related Complications in a Patient with Tuberculous Lymphadenopathy

EBUS-TBNA-related Complications in a Patient with Tuberculous Lymphadenopathy

Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing intrathoracic tuberculous lymphadenitis.

A Case of Pulmonary Tuberculosis with Bilateral Hilar Lymphadenopathy Diagnosed by Sputum Culture Subsequent to Open Thoracic Biopsy

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