Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing mediastinal lymphadenopathy: Experience from a tertiary care centre

Q2 Medicine

Medical Journal Armed Forces India Pub Date : 2024-12-01 DOI:10.1016/j.mjafi.2022.06.021

Robin Choudhary , Vikas Marwah , Pradeep Behal , P. Sengupta , Virender Malik , Shipra Verma , I.M. Pandey , Tentu Ajai Kumar , Amit Wasan

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引用次数: 0

Abstract

Background

The evaluation of mediastinal lymphadenopathy and masses poses a diagnostic challenge because of a myriad of possible etiologic causes; their proximity to numerous vital structures and the difficulty of access for biopsy. Computed tomography is an excellent modality for the initial evaluation of mediastinal lymph nodes (LNs). Tissue diagnosis is of paramount importance to confirm the diagnosis of mediastinal lymphadenopathy. Of various modalities including CT-guided biopsy, mediastinoscopy is considered a gold standard for tissue acquisition, but it is associated with considerable morbidity. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive method of sampling of mediastinal LNs and its role has been established in malignant cause of LN enlargement. However, its role in diagnosing benign diseases has not been studied much.

Methods

In a cross-sectional observational study, we performed EBUS-TBNA of 116 patients, and the sample was evaluated by various pathological modalities.

Results

Most common LN sampled was subcarinal (68%). MTB gene Xpert was positive in 45 cases, and resistance was detected in 3 cases. Most common diagnosis was tuberculous lymphadenitis (67.9%). Only five of our patients had post-operative bronchospasm, while four had peri-operative hypoxia, which was managed with oxygen therapy.

Conclusion

EBUS-TBNA is an excellent modality for sampling mediastinal LNs, which is very safe and can be done on an OPD basis.

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支气管内超声引导下经支气管针抽吸诊断纵隔淋巴结病：三级护理中心的经验

背景：由于各种可能的病因，对纵隔淋巴结病变和肿块的评估提出了诊断挑战；它们靠近许多重要结构，难以进行活检。计算机断层扫描是初步评估纵隔淋巴结（LNs）的一种极好的方式。组织诊断对纵隔淋巴结病的诊断至关重要。在包括ct引导活检在内的各种方式中，纵隔镜检查被认为是组织获取的金标准，但它与相当高的发病率相关。支气管超声引导下经支气管针吸（EBUS-TBNA）是一种微创纵隔淋巴结取样方法，其在恶性淋巴结扩大中的作用已被证实。然而，其在良性疾病诊断中的作用尚未得到充分研究。方法在横断面观察研究中，我们对116例患者进行了EBUS-TBNA，并对样本进行了各种病理检查。结果隆突下淋巴结最常见（68%）。MTB基因Xpert阳性45例，耐药3例。最常见的诊断是结核性淋巴结炎（67.9%）。只有5例患者出现术后支气管痉挛，而4例患者出现围手术期缺氧，经氧疗治疗。结论ebus - tbna是一种较好的纵隔淋巴结取样方法，安全可靠，可在OPD基础上进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Journal Armed Forces India Medicine-Medicine (all)

CiteScore

3.40

自引率

0.00%

发文量

206

期刊介绍： This journal was conceived in 1945 as the Journal of Indian Army Medical Corps. Col DR Thapar was the first Editor who published it on behalf of Lt. Gen Gordon Wilson, the then Director of Medical Services in India. Over the years the journal has achieved various milestones. Presently it is published in Vancouver style, printed on offset, and has a distribution exceeding 5000 per issue. It is published in January, April, July and October each year.