Korean J Intern Med.  2013 Nov;28(6):660-667. 10.3904/kjim.2013.28.6.660.

The diagnostic efficacy and safety of endobronchial ultrasound-guided transbronchial needle aspiration as an initial diagnostic tool

• Choi YR
• An JY
• Kim MK
• Han HS
• Lee KH
• Kim SW
• Lee KM
• Choe KH

• KMID: 1780126
• DOI: http://doi.org/10.3904/kjim.2013.28.6.660

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.

Keyword

Endobronchial ultrasound-guided transbronchial needle aspiration; Mediastinal mass; Intrathoracic mass

MeSH Terms

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