Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis of Lymphoma

Abstract

<b>Background:</b> Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is highlyaccurate in diagnosing mediastinal lymphadenopathies of lung cancer and benign disorders. However, the utilityof EBUS-TBNA in the diagnosis of mediastinal lymphomas is unclear. The aim of this study was to determinethe diagnostic value of EBUS-TBNA in patients with suspected lymphoma. Materials and <br/><b>Methods</b>: Sixty-eightpatients with isolated mediastinal lymphadenopathy and suspected of lymphoma were included in the study.EBUS-TBNA was performed on outpatients under moderate sedation. The sensitivity, specificity, negativepredictive value and diagnostic accuracy of EBUS-TBNA were calculated. <br/><b>Results</b>: Sixty-four patients werediagnosed by EBUS-TBNA, but four patients with non-diagnostic EBUS-TBNA required surgical procedures.Thirty-five (51.5%) patients had sarcoidosis, six (8.8%) had reactive lymphadenopathy, nine (13.3%) hadtuberculosis, one (1.5%) had squamous cell carcinoma, two (2.9%) had sarcoma and fifteen (22%) had lymphoma(follicular center cell, large B-cell primary, and Hodgkin lymphomas in three, two, and ten, respectively). Of the15 lymphoma patients, thirteen were diagnosed by EBUS and two by thoracotomy and mediastinoscopy. Thesensitivity, specificity, negative predictive value, and diagnostic accuracy of EBUS-TBNA for the diagnosis oflymphoma were calculated as 86.7%, 100%, 96.4%, and 97%, respectively. <br/><b>Conclusions</b>: EBUS-TBNA can beemployed in the diagnosis of mediastinal lymphoma, instead of more invasive surgical procedures.