scholarly journals Тhe value of transbronchial needle aspiration cytology in the diagnosis of stage I and II sarcoidosis

2017 ◽  
Vol 74 (6) ◽  
pp. 536-542
Author(s):  
Zeljka Tatomirovic ◽  
Vesna Skuletic ◽  
Dragana Pekovic ◽  
Vukoica Karlicic ◽  
Branka Djurovic ◽  
...  

Background/Aim. Sarcoidosis is a multisystem infmammatory disease of unknown etiology, with the lungs and intrathoracic lymph nodes the most commonly involved. The aim of this study was to assess the contribution of conventional transbronchial needle aspiration (TBNA) cytology in the diagnosis of sarcoidosis presenting as mediastinal/hilar lymphadenopathy. Methods. In this retrospective study, 58 patients with suspicion of stage I and II sarcoidosis underwent first flexibile, and then, a rigid bronhoscopy, during which TBNA of mediastinal or hilar lumph node with a 19 gauge (G) needle was done. Material from the needle was put on glass slide and prepared for the cytological and histopathological examination. Results. Out of 58 patients submitted to TBNA of mediastinal or hilar lymph nodes, adequate material for cytological diagnostics was obtained in 53 (91.37%). Out of 53 adequate cytological samples, in 38 (71.69%) noncaseous granulomatous inflammation (NGI) was found, while in corresponding histopathological samples, NGI was found in 48 (90.56%), which was significantly higher (p < 0.05). Of cytological smears, out of the cell types typical for granulomatous inflammation, in 26 (63.15%) patients the clusters of the epitheloid cells were found, in 8 (21.05%) there were both, clusters of epitheloid cells and giant multinuclear hystiocytes, and in 6 (15.76%) only single scattered epitheloid cells or small clusters of several epitheloid cells were found. The sensitivity of TBNA cytology in our group of patients with sarcoidosis was 76%, specificity 100% and accuracy 77.34%. Conclusion. TBNA is an efficient and safe procedure in the diagnosis of sarcoidosis, minimally invasive and with a little risk of complications. Using 19 G needle enables obtaining material for histological and cytological analyses, as well which contribute to the sensitivity of diagnosting sarcoidosis. The value of this type of diagnostics depends on qualification and experience both of bronchoscopist and cytologist/pathologist, as well, of the interpreter of such a material.

2019 ◽  
Vol 08 (01) ◽  
pp. e11-e13
Author(s):  
Ioannis Bougioukas ◽  
Ralf Seipelt ◽  
Hanno Huwer

Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a very useful diagnostic tool for the assessment of enlarged mediastinal and hilar lymph nodes. It is a safe procedure with a low risk of complications. Case Description We report a case of bronchial fistula and pneumomediastinum after EBUS-TBNA, which was performed shortly after a mediastinoscopy. Due to the extent of the bronchial lesion, a surgical closure of the bronchial fistula was necessary. The patient recovered completely. Conclusion The performance of EBUS-TBNA shortly after a mediastinoscopy should not be recommended to avoid possible procedure-related complications.


2006 ◽  
Vol 28 (5) ◽  
pp. 910-914 ◽  
Author(s):  
F. J. F. Herth ◽  
A. Ernst ◽  
R. Eberhardt ◽  
P. Vilmann ◽  
H. Dienemann ◽  
...  

2021 ◽  
Vol 2 (4) ◽  
pp. 296-305
Author(s):  
Francesca Signorini ◽  
Martina Panozzi ◽  
Agnese Proietti ◽  
Greta Alì ◽  
Olivia Fanucchi ◽  
...  

Introduction: In recent years, there has been a growing development of molecularly targeted therapies for various types of solid tumors—in particular, in non-small-cell lung cancer (NSCLC). This has required the need for greater quantities of tissue that is able to support ancillary studies, alongside cyto-histological diagnoses for the assessment of molecular targets. Conventional TBNA (cTBNA) and EBUS-guided TBNA (EBUS-TBNA) have shown a high diagnostic yield for malignant mediastinal and/or hilar lymph node enlargement and peribronchial masses; however, few studies have compared these two procedures. We retrospectively compared TBNA patients (EBUS-TBNA and cTBNA) in order to determine the diagnostic yield and material adequacy for subsequent ancillary analyses. Materials and Methods: We retrospectively evaluated 318 patients with clinical suspicion of lung cancer or with disease recurrence. All of the patients underwent TBNA (either EBUS-TBNA or cTBNA) on enlarged mediastinal and/or hilar lymph nodes and peribronchial masses between January 2017 and June 2021 at the University Hospital of Pisa, Italy. After a definitive diagnosis, molecular analyses and an evaluation of PD-L1 expression were performed in the cases of adenocarcinoma, squamous cell carcinoma, and NSCLC, not otherwise specified (NOS). Results: EBUS-TBNA was performed in 199 patients and cTBNA was performed in 119 patients with 374 and 142 lymph nodes, respectively. The overall diagnostic yield for positive diagnoses was 59% (diagnostic rate of 61% in EBUS-TBNA, and 55% in cTBNA). Adenocarcinoma (ADC) was the most frequent diagnosis in both methods. EBUS-TBNA diagnostic adequacy was 72% for molecular analysis, while it was 55.5% for cTBNA, showing a statistical trend (p = 0.08) towards the significance of EBUS. The average percentage of neoplastic cells was also statistically different between the two methods (p = 0.05), reaching 51.19 ± 22.14 in EBUS-TBNA and 45.25 ± 22.84 in cTBNA. With regard to the PD-L1 protein expression, the percentage of positivity was similar in both procedures (86% in EBUS-TBNA, 85% in cTBNA). Conclusions: Conventional TBNA (cTBNA) and EBUS-guided TBNA (EBUS-TBNA) are minimally invasive diagnostic methods that are associated with a high diagnostic yield. However, EBUS-TBNA has an improved diagnostic adequacy for molecular analysis compared to cTBNA, and is associated with a higher average percentage of neoplastic cells.


2015 ◽  
Vol 41 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Viviane Rossi Figueiredo ◽  
Paulo Francisco Guerreiro Cardoso ◽  
Márcia Jacomelli ◽  
Sérgio Eduardo Demarzo ◽  
Addy Lidvina Mejia Palomino ◽  
...  

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil. Methods: This was a retrospective analysis of patients diagnosed with lung cancer and submitted to EBUS-TBNA for mediastinal lymph node staging. The EBUS-TBNA procedures, which involved the use of an EBUS scope, an ultrasound processor, and a compatible, disposable 22 G needle, were performed while the patients were under general anesthesia. Results: Between January of 2011 and January of 2014, 149 patients underwent EBUS-TBNA for lymph node staging. The mean age was 66 ± 12 years, and 58% were male. A total of 407 lymph nodes were sampled by EBUS-TBNA. The most common types of lung neoplasm were adenocarcinoma (in 67%) and squamous cell carcinoma (in 24%). For lung cancer staging, EBUS-TBNA was found to have a sensitivity of 96%, a specificity of 100%, and a negative predictive value of 85%. Conclusions: We found EBUS-TBNA to be a safe and accurate method for lymph node staging in lung cancer patients.


Respiration ◽  
2008 ◽  
Vol 76 (2) ◽  
pp. 218-220 ◽  
Author(s):  
Virginia Leiro ◽  
Alberto Fern&aacute;ndez-Villar ◽  
Rafael Bandr&eacute;s ◽  
Ana Gonz&aacute;lez ◽  
Cristina Represas ◽  
...  

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