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. 2015 Jan-Feb;32(1):6-10.
doi: 10.4103/0970-2113.148399.

Endoscopic ultrasound-guided fine-needle aspiration with an echobronchoscope in undiagnosed mediastinal lymphadenopathy: First experience from India

Sahajal Dhooria  1 , Ashutosh Nath Aggarwal  1 , Navneet Singh  1 , Dheeraj Gupta  1 , Digamber Behera  1 , Nalini Gupta  2 , Ritesh Agarwal  1
Affiliations

Endoscopic ultrasound-guided fine-needle aspiration with an echobronchoscope in undiagnosed mediastinal lymphadenopathy: First experience from India

Sahajal Dhooria et al. Lung India. 2015 Jan-Feb.

Abstract

Background and aim: Several studies have reported the performance of combining endoscopic ultrasound fine-needle aspiration with an echobronchoscope (EUS-B-FNA), with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), for the diagnosis of mediastinal lymphadenopathy. Herein we report our initial experience with this technique.

Patients and methods: In this retrospective study, we report the outcome of patients who underwent EUS-B-FNA with or without EBUS-TBNA during the same session. Details of the lymph nodes sampled, number of passes, duration of the procedure, results of the cytological examination, and the final diagnosis of all the patients are presented.

Results: Eleven patients underwent EUS-B-FNA during the study period. EUS-B-FNA and EBUS-TBNA together yielded a sensitivity and specificity of 72.7 and 100%, respectively. The number of lymph nodes sampled per patient and the number of passes per lymph node were significantly higher with EBUS-TBNA compared to EUS-B-FNA. The mean duration of procedure was also significantly higher in the EBUS-TBNA group. The most common reason (five patients (45.5%)) for resorting to EUS-B-FNA was the patient being unfit for EBUS-TBNA or the inability of the operator to complete the procedure. Sarcoidosis was the most frequent final diagnosis in the study patients (four cases), followed by bronchogenic carcinoma (three cases).

Conclusions: EUS-B-FNA is a useful additional tool for the diagnosis of mediastinal lymphadenopathy. In combination with EBUS-TBNA, it has a fairly good diagnostic yield and is a good alternative in situations where EBUS-TBNA is not feasible.

Keywords: Bronchoscopy; EBUS; TBNA; lung cancer; sarcoidosis; transbronchial needle aspiration; tuberculosis.

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Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Agarwal R, Aggarwal AN, Gupta D. Efficacy and safety of conventional transbronchial needle aspiration in sarcoidosis: A systematic review and meta-analysis. Respir Care. 2013;58:683–93. - PubMed
    1. Khan A, Agarwal R, Aggarwal AN, Gupta N, Bal A, Singh N, et al. Blind transbronchial needle aspiration without an on-site cytopathologist: Experience of 473 procedures. Natl Med J India. 2011;24:136–9. - PubMed
    1. Rami-Porta R, Call S. Invasive staging of mediastinal lymph nodes: Mediastinoscopy and remediastinoscopy. Thorac Surg Clin. 2012;22:177–89. - PubMed
    1. Goyal A, Gupta D, Agarwal R, Bal A, Nijhawan R, Aggarwal AN. Value of different bronchoscopic sampling techniques in diagnosis of sarcoidosis: A prospective study of 151 patients. J Bronchology Interv Pulmonol. 2014;21:220–6. - PubMed
    1. Yasufuku K, Chhajed PN, Sekine Y, Nakajima T, Chiyo M, Iyoda A, et al. Endobronchial ultrasound using a new convex probe: A preliminary study on surgically resected specimens. Oncol Rep. 2004;11:293–6. - PubMed