Abstract

Objective: One of the indications for endobronchial ultrasound (EBUS) is the diagnosis of mediastinal and/or hilar lymphadenopathy. The aim of this study is to report the place of EBUS probe using a single- channel bronchoscope that allows TBNA after localisation of lymph nodes under ultrasound in the diagnosis of mediastinal and hiler lymph nodes.

Material and Method: Retrospectively, 45 patients were enrolled with a proven lymph node on CT and an indication for TBNA for diagnosis. Lymph nodes were verified under local anesthesia by EBUS and sampled using a Wang 22 gauge cytology needle. The EU-M30s model EBUS and UM-BS 20-26 R Olympus ultrasonic probe was used. Procedures were applied through Pentax EB 1970 model bronchoscope.

Results: TBNA procedures were performed using a flexible bronchoscope and a 22-gauge Wang needle in 45 consecutive patients (23 women (51.1%); mean age, 47±15 years [+/- SD] (17-74)) who had mediastinal or hilar adenopathy identified on chest CT The average number of needle passes was 5.0±1.8 (2-9) per patient. A total of 85 lymph nodes were sampled. Adequate material was found in all of the patients (100%). In 36 (80.0%) of the cases the adequate material was diagnostic. The diagnostic value of EBUS TBNA was 82.4% in sarcoidosis, 60% in tuberculosis and 100% in small cell lung carcinoma and nonsmall cell lung carcinoma.

Conclusion: EBUS guided TBNA of mediastinal and hilar lymph nodes is a safe approach which increases the percentage of adequate material and diagnostic yield.