Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in diagnosis of mediastinal lesions.

Ricardo Sales Dos Santos, Marcia Jacomelli, Juliana Pereira Franceschini, Iunis Suzuki, Altair da Silva Costa, Christina Shiang, Addy Lidvina Mejia Palomino
Author Information
  1. Ricardo Sales Dos Santos: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  2. Marcia Jacomelli: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  3. Juliana Pereira Franceschini: Centro Universitário São Camilo, São Paulo, SP, Brazil.
  4. Iunis Suzuki: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  5. Altair da Silva Costa: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  6. Christina Shiang: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  7. Addy Lidvina Mejia Palomino: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Abstract

OBJECTIVE: To describe the results of endobronchial ultrasound-guided transbronchial needle aspiration in making diagnosis of mediastinal injuries associated to different causes.
METHODS: A retrospective cross-sectional study of patients submitted to Endobronchial ultrasound-guided transbronchial needle aspiration at a private organization, between June 2013 and October 2016. All cases referred for collection of lymph nodes or peritracheal/peribronchial masses by endobronchial ultrasound-guided transbronchial needle aspiration, and evaluated through tomography or PET-CT were included. Interventional pulmonologists and thoracic surgeons with experience in the method did the procedures. Rapid on-site evaluation of fine needle aspiration was performed by an experienced pathologist. Material analysis included cytological smear and cytopathological analysis of paraffin-embedded cell blocks. Other specific analyses (immunocytochemistry, tests and cultures of infectious agents) were performed whenever necessary.
RESULTS: We included 72 patients; 6 were excluded for presenting endobronchial lesions in which bronchoscopic biopsy could be performed, or intrathoracic lesions that were not accessible by endobronchial ultrasound-guided transbronchial needle aspiration. The mean age of 66 patients included for analysis was 61.17 years (±14.67 years), with a predominance of males (64%). Endobronchial ultrasound-guided transbronchial needle aspiration was definitive for diagnosis in 60 cases (91%). Three cases (4.5%) had inconclusive test results. There were no major complications related to the procedure.
CONCLUSION: Endobronchial ultrasound-guided transbronchial needle aspiration had a high diagnosis yield, with minimal morbidity, being an excellent option for diagnostic approach of patients with lymphadenopathy or intrathoracic lesions, and for neoplasm staging.

References

  1. Chest. 2013 May;143(5 Suppl):e211S-e250S [PMID: 23649440]
  2. Respir Med. 2012 Jun;106(6):883-92 [PMID: 22417738]
  3. Eur J Cancer. 2009 May;45(8):1389-96 [PMID: 19124238]
  4. Thorax. 1992 Jul;47(7):565-7 [PMID: 1412103]
  5. Eur J Cardiothorac Surg. 2014 May;45(5):787-98 [PMID: 24578407]
  6. Clinics (Sao Paulo). 2009;64(6):499-504 [PMID: 19578652]
  7. Respiration. 2014;88(6):500-17 [PMID: 25377908]
  8. J Thorac Oncol. 2009 May;4(5):568-77 [PMID: 19357537]
  9. Chest. 2010 Sep;138(3):641-7 [PMID: 20382710]
  10. Eur J Cancer. 2013 May;49(8):1860-7 [PMID: 23481511]
  11. Lung Cancer. 2005 Dec;50(3):347-54 [PMID: 16171897]
  12. J Thorac Oncol. 2009 Aug;4(8):947-50 [PMID: 19590457]
  13. Am J Clin Pathol. 2008 Sep;130(3):434-43 [PMID: 18701418]
  14. Thorax. 2009 Sep;64(9):757-62 [PMID: 19454408]
  15. Acta Cytol. 2008 Nov-Dec;52(6):687-90 [PMID: 19068672]
  16. J Bras Pneumol. 2012 Jan-Feb;38(1):33-40 [PMID: 22407038]
  17. J Thorac Dis. 2016 Oct;8(Suppl 9):S690-S696 [PMID: 28066671]
  18. J Bras Pneumol. 2015 Jan-Feb;41(1):23-30 [PMID: 25750671]
  19. Ann Thorac Surg. 2013 Oct;96(4):1502-7 [PMID: 23993894]

MeSH Term

Aged
Bronchoscopy
Cross-Sectional Studies
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Female
Humans
Lymph Nodes
Male
Mediastinal Diseases
Mediastinum
Middle Aged
Paraffin Embedding
Positron Emission Tomography Computed Tomography
Reproducibility of Results
Retrospective Studies

Word Cloud

Created with Highcharts 10.0.0needleaspirationultrasound-guidedtransbronchialendobronchialdiagnosispatientsEndobronchialincludedlesionscasesperformedanalysisresultsmediastinalintrathoracicyearsOBJECTIVE:describemakinginjuriesassociateddifferentcausesMETHODS:retrospectivecross-sectionalstudysubmittedprivateorganizationJune2013October2016referredcollectionlymphnodesperitracheal/peribronchialmassesevaluatedtomographyPET-CTInterventionalpulmonologiststhoracicsurgeonsexperiencemethodproceduresRapidon-siteevaluationfineexperiencedpathologistMaterialcytologicalsmearcytopathologicalparaffin-embeddedcellblocksspecificanalysesimmunocytochemistrytestsculturesinfectiousagentswhenevernecessaryRESULTS:726excludedpresentingbronchoscopicbiopsyaccessiblemeanage666117±1467predominancemales64%definitive6091%Three45%inconclusivetestmajorcomplicationsrelatedprocedureCONCLUSION:highyieldminimalmorbidityexcellentoptiondiagnosticapproachlymphadenopathyneoplasmstagingEBUS-TBNA

Similar Articles

Cited By (3)