The diagnostic efficacy and safety of endobronchial ultrasound-guided transbronchial needle aspiration as an initial diagnostic tool.
10.3904/kjim.2013.28.6.660
- Author:
Young Rak CHOI
1
;
Jin Young AN
;
Mi Kyeong KIM
;
Hye Suk HAN
;
Ki Hyeong LEE
;
Si Wook KIM
;
Ki Man LEE
;
Kang Hyeon CHOE
Author Information
1. Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. drahnjy@chungbuk.ac.kr
- Publication Type:Original Article
- Keywords:
Endobronchial ultrasound-guided transbronchial needle aspiration;
Mediastinal mass;
Intrathoracic mass
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Biopsy, Large-Core Needle;
*Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects;
Female;
Humans;
Lung Diseases/*pathology/radiography;
Lung Neoplasms/pathology;
Lymph Nodes/*pathology/radiography;
Lymphatic Metastasis;
Male;
Mediastinoscopy;
Middle Aged;
Neoplasm Staging;
Predictive Value of Tests;
Retrospective Studies;
Risk Factors;
Tomography, X-Ray Computed;
Young Adult
- From:The Korean Journal of Internal Medicine
2013;28(6):660-667
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Real-time, convex probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used for the staging of malignant mediastinal lymph nodes. We evaluated the diagnostic efficacy and safety of EBUS-TBNA when used as an initial diagnostic tool. METHODS: We retrospectively studied 56 patients who underwent EBUS-TBNA as an initial diagnostic tool between August 2010 and December 2011. Procedure purpose were classified into four categories: 1) intrathoracic masses adjacent to the central airway; 2) enlarged lymph nodes for concurrent diagnosis and staging in suspected malignancy; 3) enlarged lymph nodes in suspected malignancy cases with inability to perform percutaneous core needle biopsy (PCNB); and 4) solely mediastinal masses/lymph nodes in lieu of mediastinoscopy. RESULTS: The diagnostic accuracy of EBUS-TBNA regardless of procedure purpose was calculated to be 83.9%. Furthermore, the diagnostic accuracy of malignant disease was significantly higher than benign disease (93.9% vs. 70.6%, p < 0.001). The diagnostic accuracy of EBUS-TBNA for each disease is as follows: tuberculosis, 50%; sarcoidosis, 60%; aspergillosis, 100%; lung abscess, 100%; lung cancer, 93%; and lymphoma, 100%. There were minor complications in seven patients during the EBUS-TBNA procedure. The complications included mild hypoxia and bleeding. CONCLUSIONS: In conclusion, EBUS-TBNA is a useful initial diagnostic tool for both benign and malignant diseases. EBUS-TBAN is also a very safe procedure and less invasive compared to mediastinoscopy or PCNB.
