Evaluation of the Usefulness of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in the Diagnosis of Hilar or Mediastinal Lymphadenopathy

DOI 15 References
  • Kaneda Hiroyasu
    Department of Medical Oncology, Kinki University Faculty of Medicine
  • Miyazaki Masaki
    Department of Medical Oncology, Kinki University Faculty of Medicine
  • Kiyota Hidemi
    Department of Medical Oncology, Kinki University Faculty of Medicine
  • Tanaka Kaoru
    Department of Medical Oncology, Kinki University Faculty of Medicine
  • Hayashi Hidetoshi
    Department of Medical Oncology, Kinki University Faculty of Medicine
  • Tsurutani Junji
    Department of Medical Oncology, Kinki University Faculty of Medicine
  • Kurata Takayasu
    Department of Medical Oncology, Kinki University Faculty of Medicine
  • Okamoto Isamu
    Department of Medical Oncology, Kinki University Faculty of Medicine
  • Nakagawa Kazuhiko
    Department of Medical Oncology, Kinki University Faculty of Medicine

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  • 当科における肺門および縦隔リンパ節腫大の診断におけるEBUS-TBNAの有用性の検討

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Abstract

Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) represents a new technology in the field of bronchoscopy. EBUS-TBNA has been well established as a useful and safe procedure in the evaluation of mediastinal and/or hilar lymphadenopathies. Objective. The aim of the present study was to assess the utility of EBUS-TBNA in confirming pathological diagnoses. Methods. Fifty-one patients with mediastinal and/or hilar lymphadenopathies who underwent EBUS-TBNA for pathological diagnosis between April 2009 and March 2011 were retrospectively analyzed. Results. A total of 58 mediastinal or hilar lymph nodes in 51 patients were examined. EBUS-TBNA confirmed diagnosis in 44 of 51 patients (86.3%) by pathological diagnosis in 48 of 58 lymph nodes samples (82.7%). EBUS-TBNA confirmed diagnoses of malignancy in 32 patients, and benign diseases in 14 cases, including tuberculosis, sarcoidosis, and inflammatory diseases. The remaining 5 patients with negative EBUS-TBNA results were found to have pathological diagnoses by computed tomographic-guided percutaneous needle biopsy or mediastinoscopic biopsy. The respective sensitivity of EBUS-TBNA at individual lymph node stations were as follows: right paratracheal aspirates, 75%; subcarinal aspirates, 89%; left interlobar aspirates, 80%; other lymph node station aspirates, 100%; and overall, 82.8%. Moreover, the respective diagnostic yield 5 of aspiration according to lymph node size were as follows: 10-15 mm, 60%; 16-20 mm, 68%; 21-25 mm, 83%; greater than 25 mm, 100%. There were no complications associated with the procedures. Conclusion. We obtained a diagnostic accuracy rate comparable with that of several systematic reviews. In this study, EBUS-TBNA was shown to have a high diagnostic yield and is less invasive as a procedure for evaluating mediastinal or/and hilar lymphadenopathies.

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