Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal and hilar lesions

Abstract

Objective To investigate the application, diagnostic value and safety of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in hilar and mediastinal lesions. Methods A total of 246 patients with thoracic computed tomography (CT) examinations showed mediastinal, hilar lymphadenopathy and/or pleural masses, which were examined for EBUS-TBNA in the department of respiratory medicine, Second Affiliated Hospital of Chongqing Medical University from October 2014 to September 2016.The results of cytology or pathology, the positive rate of diagnosis and the incidence of complications were analyzed. Results In the 246 patients, there were 130 cases of malignant tumors, 72 cases of benigh diseases and 26 cases of suspicious cancer, but 18 cases′ pathological diagnosis couldn′t be definite.In malignant tumors cases, 45 cases were small cell lung cancer and 39 non-small cell lung cancer, 42 cases of non-specific type, 1 case of metastatic neuroendocrine carcinoma, 2 cases of type B lymphoma and 1 case of primary mediastinal sarcoma.In benign disease, there were 22 cases of non-specific inflammation, 2 cases of mediastatic cyst, 1 case of pulmonary abscess, 1 case of pulmonary cyst with actinomycete infection, 8 cases of pneumoconiosis, 27 cases of mediastinal lymph node tuberculosis, and 11 cases of sarcoidosis. Conclusions EBUS-TBNA is of great value in the diagnosis of unexplained hilar, mediastinal lymph node enlargement or hilar and mediastinal epiphyseal lesions, especially for the diagnosis of sarcoidosis.It is also an important auxiliary examination to diagnosis of the rare hilar and mediastinal dieases. Key words: Bronchoscopy; Ultrasonography; Biopsy, needle; Diagnosis