RT Journal Article
SR Electronic
T1 Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lymphoma
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 360
OP 365
DO 10.1136/thx.2007.084079
VO 63
IS 4
A1 Kennedy, M P
A1 Jimenez, C A
A1 Bruzzi, J F
A1 Mhatre, A D
A1 Lei, X
A1 Giles, F J
A1 Fanning, T
A1 Morice, R C
A1 Eapen, G A
YR 2008
UL http://thorax.bmj.com/content/63/4/360.abstract
AB Background: The diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of lymphoma in patients with mediastinal lymphadenopathy is not well defined.Methods: A retrospective review was performed of all patients with mediastinal lymphadenopathy referred for EBUS-TBNA between August 2005 and December 2006 in whom lymphoma was suspected based on prior history or clinical presentation. Mediastinal biopsy specimens were taken using a linear array ultrasonic bronchoscope (Olympus XBF-UC 160F) and a 22-gauge cytology needle (NA-202C Olympus) with on-site cytopathological support. The EBUS-TBNA result was compared with a reference standard of pathological tissue diagnosis or a composite of ⩾6 months of clinical follow-up with radiographic imaging.Results: Of 236 patients who underwent EBUS-TBNA, 25 were eligible for inclusion. Indications for EBUS-TBNA were suspected mediastinal recurrence of lymphoma (n = 13) and mediastinal lymphadenopathy of unknown cause (n = 12). Adequate lymph node sampling was accomplished in 24/25 patients (96%); there were no complications. EBUS-TBNA identified lymphoma in 10 patients and benign disease in 14 patients. There was one false negative EBUS-TBNA for lymphoma (lymphoma prevalence 11/25 (44%)). Follow-up over a median of 10.5 months (range 1–19) confirmed stable or regressive lymphadenopathy in all 14 patients without a lymphoma diagnosis, consistent with a benign diagnosis. Overall, EBUS-TBNA had a sensitivity of 90.9%, specificity of 100%, positive predictive value of 100% and negative predictive value of 92.9% for the diagnosis of lymphoma.Conclusions: EBUS-TBNA is an accurate, safe and useful tool in the investigation of suspected lymphoma with isolated mediastinal adenopathy, and may diminish the need for more invasive procedures such as mediastinoscopy.