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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Efficacy of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in the Diagnosis of Mediastinal and Hilar Lesions

Author(s): Ting Liu, Wenli Zhang, Chunmei Liu*, Leqiang Wang, Haipeng Gao and Xiaoxue Jiang

Volume 20, 2024

Published on: 07 July, 2023

Article ID: e280423216353 Pages: 7

DOI: 10.2174/1573405620666230428121243

open_access

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Abstract

Background: Mediastinal and hilar lesions may be benign or malignant. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is increasingly used for the diagnosis of these lesions as it is both minimally invasive and safe.

Objective: To investigate the clinical efficacy of EBUS-TBNA in the diagnosis and differential diagnosis of mediastinal and hilar lesions.

Methods: A retrospective observational study was undertaken to investigate patients diagnosed with mediastinal and hilar lymphadenopathy based on imaging at our hospital from 2020 to 2021. After evaluation, EBUS TBNA was used and data including the puncture site, postoperative pathology, and complications were recorded.

Results: Data from 137 patients were included in the study, of which 135 underwent successful EBUS TBNA. A total of 149 lymph node punctures were performed, of which 90 punctures identified malignant lesions. The most common malignancies were small-cell lung carcinoma, adenocarcinoma, and squamous cell carcinoma. Forty-one benign lesions were identified, resulting from sarcoidosis, tuberculosis, and reactive lymphadenitis, amongst others. Follow-up findings showed that 4 cases were malignant tumors, with 1 case of pulmonary tuberculosis and 1 case of sarcoidosis). Four specimens where lymph node puncture was insufficient were subsequently confirmed by other means. The sensitivity of EBUS TBNA for malignant lesions, tuberculosis and sarcoidosis in mediastinal and hilar lesions was 94.7%, 71.4%, and 93.3%, respectively. Similarly, the negative predictive values (NPV) were 88.9%, 98.5%, and 99.2%, and the accuracy was 96.3%, 98.5%, and 99.3%.

Conclusion: EBUS TBNA is an effective and feasible approach for the diagnosis of mediastinal and hilar lesions that is minimally invasive and safe.

Keywords: Ultrasound bronchoscopy, Needle biopsy, Mediastinal benign lesions, Mediastinal malignant lesions, Hilar lesions, Diagnosis.

[1]
Dincer HE. Linear EBUS in staging non-small cell lung cancer and diagnosing benign diseases. J Bronchology Interv Pulmonol 2013; 20(1): 66-76.
[http://dx.doi.org/10.1097/LBR.0b013e31827d1514] [PMID: 23328148]
[2]
Divisi D, Zaccagna G, Barone M, Gabriele F, Crisci R. Endobronchial ultrasound-transbronchial needle aspiration (EBUS/TBNA): A diagnostic challenge for mediastinal lesions. Ann Transl Med 2018; 6(5): 92-9.
[http://dx.doi.org/10.21037/atm.2017.12.19] [PMID: 29666815]
[3]
Petranovic M, Gilman MD, Muniappan A, et al. Diagnostic yield of CT-guided percutaneous transthoracic needle biopsy for diagnosis of anterior mediastinal masses. AJR Am J Roentgenol 2015; 205(4): 774-9.
[http://dx.doi.org/10.2214/AJR.15.14442] [PMID: 26397325]
[4]
El-Sherief AH, Lau CT, Wu CC, Drake RL, Abbott GF, Rice TW. International association for the study of lung cancer (IASLC) lymph node map: Radiologic review with CT illustration. Radiographics 2014; 34(6): 1680-91.
[http://dx.doi.org/10.1148/rg.346130097] [PMID: 25310423]
[5]
Conte SC, Spagnol G, Biolo M, Confalonieri M. A retrospective study of endobronchial ultrasound transbronchial needle aspiration versusconventional transbronchial needle aspiration in diagnosis/staging of hilar/mediastinal lymph node in lung cancer: Which role in clinical practice? Monaldi Arch Chest Dis 2019; 89(1): 1010-4.
[http://dx.doi.org/10.4081/monaldi.2019.1010] [PMID: 30996353]
[6]
Lin CK, Keng LT, Lim CK, et al. Diagnosis of mediastinal tuberculous lymphadenitis using endobronchial ultrasound-guided transbronchial needle aspiration with rinse fluid polymerase chain reaction. J Formos Med Assoc 2020; 119(1): 509-15.
[http://dx.doi.org/10.1016/j.jfma.2019.07.014] [PMID: 31377114]
[7]
Kasper L, Andrychiewicz A, Gross-Sondej I, et al. Combination of endosonography-guided fine-needle aspiration and conventional endoscopic techniques in sarcoidosis diagnosis. Optimal strategy to achieve high diagnostic yield. Clin Respir J 2021; 15(2): 203-8.
[http://dx.doi.org/10.1111/crj.13285] [PMID: 33012129]
[8]
Erer OF, Anar C, Erol S, Özkan S. The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy. Turk J Med Sci 2016; 46(1): 112-9.
[http://dx.doi.org/10.3906/sag-1407-113] [PMID: 27511343]
[9]
Žemaitis M, Musteikienė G, Miliauskas S, Pranys D, Sakalauskas R. Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Cytological Smears and Cell Blocks: A Single-Institution Experience. Medicina (Kaunas) 2018; 54(2): 19-28.
[http://dx.doi.org/10.3390/medicina54020019] [PMID: 30344250]
[10]
Temiz D, İn E, Kuluöztürk M, et al. The role of endobronchial ultrasound‐guided transbronchial needle aspiration in the differential diagnosis of isolated mediastinal and/or hilar lymphadenopathy. Diagn Cytopathol 2021; 49(9): 1012-21.
[http://dx.doi.org/10.1002/dc.24807] [PMID: 34078002]
[11]
Carter BW, Glisson BS, Truong MT, Erasmus JJ. Small cell lung carcinoma: Staging, imaging, and treatment considerations. Radiographics 2014; 34(6): 1707-21.
[http://dx.doi.org/10.1148/rg.346140178] [PMID: 25310425]
[12]
Carbonari A, Rossini L, Marioni F, et al. Value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of lung and mediastinal lesions. Rev Assoc Med Bras 2020; 66(9): 1210-6.
[13]
Gandotra S, Dotson T, Lamar Z, Bellinger C. Endobronchial Ultrasound Transbronchial Needle Aspiration for the Diagnosis of Lymphoma. J Bronchology Interv Pulmonol 2018; 25(2): 97-102.
[http://dx.doi.org/10.1097/LBR.0000000000000449] [PMID: 29076937]
[14]
Eickhoff L, Golpon H, Zardo P, et al. Endobronchial Ultrasound in Suspected Non-Malignant Mediastinal Lymphadenopathy. Pneumologie 2018; 72(8): 559-67.
[http://dx.doi.org/10.1055/a-0583-0265] [PMID: 29788514]
[15]
Lucey O, Potter J, Ricketts W, Castle L, Melzer M. Utility of EBUS-TBNA in diagnosing mediastinal tuberculous lymphadenitis in East London. J Infect 2022; 84(1): 17-23.
[http://dx.doi.org/10.1016/j.jinf.2021.10.015] [PMID: 34706281]
[16]
Batum Ö, Katgı N, Özdemir Ö, Yılmaz U. Diagnostic efficacy of EBUS‐TBNA in benign diseases in a population with a high prevalence of tuberculosis. Diagn Cytopathol 2021; 49(3): 374-80.
[http://dx.doi.org/10.1002/dc.24661] [PMID: 33197137]
[17]
Scano V, Fois AG, Manca A, et al. Role of EBUS-TBNA in Non-Neoplastic Mediastinal Lymphadenopathy: Review of Literature. Diagnostics (Basel) 2022; 12(2): 512-27.
[http://dx.doi.org/10.3390/diagnostics12020512] [PMID: 35204602]
[18]
Nin CS, de Souza VVS, do Amaral RH, et al. Thoracic lymphadenopathy in benign diseases: A state of the art review. Respir Med 2016; 112: 10-7.
[http://dx.doi.org/10.1016/j.rmed.2016.01.021] [PMID: 26860219]
[19]
Olgun Yıldızeli Ş, Tufan A, Bozkurtlar E, et al. Endobronchial ultrasound transbronchial needle aspiration in elderly patients: Safety and performance outcomes EBUS-TBNA in elderly. Aging Male 2020; 23(5): 507-12.
[http://dx.doi.org/10.1080/13685538.2018.1538337] [PMID: 30457426]
[20]
Dhooria S, Sehgal IS, Gupta N, Prasad KT, Aggarwal AN, Agarwal R. Diagnostic utility and safety of endobronchial ultrasound–guided transbronchial needle aspiration in the elderly. J Bronchology Interv Pulmonol 2020; 27(1): 22-9.
[http://dx.doi.org/10.1097/LBR.0000000000000605] [PMID: 31206389]
[21]
Gianella P, Soccal PM, Plojoux J, et al. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration in malignant and nonmalignant disease. Acta Cytol 2018; 62(5-6): 380-5.
[http://dx.doi.org/10.1159/000493334] [PMID: 30244239]

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