open access

Vol 76, No 4 (2008)
ORIGINAL PAPERS
Published online: 2008-06-22
Submitted: 2013-02-22
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Ultrasound guided transbronchial needle aspiration as a diagnostic tool for lung cancer and sarcoidosis

Artur Szlubowski, Jarosław Kużdżał, Juliusz Pankowski, Anna Obrochta, Jerzy Soja, Jolanta Hauer, Marcin Kołodziej, Marcin Zieliński
Pneumonol Alergol Pol 2008;76(4):229-236.

open access

Vol 76, No 4 (2008)
ORIGINAL PAPERS
Published online: 2008-06-22
Submitted: 2013-02-22

Abstract

Introduction: The aim of the study was to assess the diagnostic yield of ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in mediastinal or hilar adenopathy in: 1) staging of non-small cell lung cancer (NSCLC) (97); 2) other malignant neoplasms including: small cell lung cancer (SCLC), metastatic neoplasms and Hodgkin’s disease (16); 3) NSCLC recurrence (7); 4) sarcoidosis and other non-malignant diseases (29).
Material and methods: Real time EBUS-TBNA was performed under local anaesthesia and sedation in 149 consecutive patients - 237 biopsies in groups of lymph nodes: subcarinal (7) - 107, all paratracheal (2R, 2L, 4R, 4L) - 86, hilar (10R, 10L) - 41 and interlobar (11R, 11L) - 3. A mean axis of punctured node was 15 mm (range: 7-42 mm). All negative results were verified by transcervical extended bilateral mediastinal lymphadenectomy (TEMLA), mediastinoscopy or thoracotomy.
Results: Lymph node biopsy was technically successful in 92% and was diagnostic in 55% of lung cancer patients and in 85.7% of sarcoidosis patients. In NSCLC staging sensitivity of EBUS-TBNA was 88.7%, specificity 100%, accuracy 92.8% and NPV 83.3% (89.7%, 100%, 94.9% and 90.9% per biopsy), and in the whole group it was 91.5%, 98.7%, 94.6% and 87.3% respectively. In 7.2% of NSCLC staging patients with false negative results of EBUS-TBNA (mainly subcarinal) there was observed partial involvement of metastatic lymph nodes, mean 34.3% (range 10–50%), confirmed by TEMLA.
Conclusion: The diagnostic value of EBUS-TBNA is very high in lung cancer, NSCLC staging and sarcoidosis.

Abstract

Introduction: The aim of the study was to assess the diagnostic yield of ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in mediastinal or hilar adenopathy in: 1) staging of non-small cell lung cancer (NSCLC) (97); 2) other malignant neoplasms including: small cell lung cancer (SCLC), metastatic neoplasms and Hodgkin’s disease (16); 3) NSCLC recurrence (7); 4) sarcoidosis and other non-malignant diseases (29).
Material and methods: Real time EBUS-TBNA was performed under local anaesthesia and sedation in 149 consecutive patients - 237 biopsies in groups of lymph nodes: subcarinal (7) - 107, all paratracheal (2R, 2L, 4R, 4L) - 86, hilar (10R, 10L) - 41 and interlobar (11R, 11L) - 3. A mean axis of punctured node was 15 mm (range: 7-42 mm). All negative results were verified by transcervical extended bilateral mediastinal lymphadenectomy (TEMLA), mediastinoscopy or thoracotomy.
Results: Lymph node biopsy was technically successful in 92% and was diagnostic in 55% of lung cancer patients and in 85.7% of sarcoidosis patients. In NSCLC staging sensitivity of EBUS-TBNA was 88.7%, specificity 100%, accuracy 92.8% and NPV 83.3% (89.7%, 100%, 94.9% and 90.9% per biopsy), and in the whole group it was 91.5%, 98.7%, 94.6% and 87.3% respectively. In 7.2% of NSCLC staging patients with false negative results of EBUS-TBNA (mainly subcarinal) there was observed partial involvement of metastatic lymph nodes, mean 34.3% (range 10–50%), confirmed by TEMLA.
Conclusion: The diagnostic value of EBUS-TBNA is very high in lung cancer, NSCLC staging and sarcoidosis.
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Keywords

endobronchial ultrasound guided transbronchial needle aspiration; transcervical extended bilateral mediastinal lymphadenectomy; non-small cell lung cancer staging; sarcoidosis

About this article
Title

Ultrasound guided transbronchial needle aspiration as a diagnostic tool for lung cancer and sarcoidosis

Journal

Advances in Respiratory Medicine

Issue

Vol 76, No 4 (2008)

Pages

229-236

Published online

2008-06-22

Bibliographic record

Pneumonol Alergol Pol 2008;76(4):229-236.

Keywords

endobronchial ultrasound guided transbronchial needle aspiration
transcervical extended bilateral mediastinal lymphadenectomy
non-small cell lung cancer staging
sarcoidosis

Authors

Artur Szlubowski
Jarosław Kużdżał
Juliusz Pankowski
Anna Obrochta
Jerzy Soja
Jolanta Hauer
Marcin Kołodziej
Marcin Zieliński

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