Diagnostic yield of EBUS-TBNA for mediastinal lymphoma

Abstract

Introduction: Endobronchial ultrasound guided-transbronchial needle aspiration (EBUS-TBNA) enables cytological examination of mediastinal lymph nodes. Lymphoma is an important disease in differantial diagnosis of mediastinal lymph node enlargement especially in young adults. Aim: In this study, we investigated the yield of EBUS-TBNA for diagnosis of lymphoma. Methods: We retrospectively evaluated our database for patients who underwent EBUS between March 2011 and December 2014. Patients with suspected lymphoma were included in the study on the basis of a history of lymphoma, or newly evaluated mediastinal lymphadenopathy. Results: There were 13 patients with final diagnosis as lymphoma. One patient underwent twice. Eleven of them were new diagnosis and two patients were known chronic lymphocytic leukemia (CLL) and underwent EBUS-TBNA for determination of recurrence.Most frequently sampled lymph node stations were, right lower paratracheal lymph nodes (4R) and subcarinal (7).Twelve EBUS-TBNA procedures were performed for suspected new cases. Three (25%) were diagnostic, 2 (16.7%) were suspicious for lymphoma and underwent further interventions for definite diagnosis and 7 (58.3%) were false negative. All of the three patients diagnosed with EBUS-TBNA were NHL. None of the HL could be diagnosed with EBUS-TBNA. Both two EBUS-TBNA procedures performed for reccurent cases were diagnostic for lymphoma. Conclusion: Thevalue of EBUS-TBNA in the diagnosis of lymphoma is controversial. EBUS-TBNA can be first diagnostic modality in diagnosis of recurrent lymphomas. But for suspected new cases -especially for HL- diagnostic yield of EBUS-TBNA is low and negative results do not exclude lymphoma.