Abstract
Mediastinal intrathoracic lymphadenopathy is a common manifestation of infection with Mycobacterium tuberculosis in HIV-infected patients and less commonly in HIV-uninfected patients. 1 Leung A.N. Brauner M.W. Gamsu G. Mlika-Cabanne N. Ben Romdhane H. Carette M.F. et al. Pulmonary tuberculosis: comparison of CT findings in HIV-seropositive and HIV-seronegative patients. Radiology. 1996; 198: 687-691 PubMed Google Scholar However, infection with HIV also predisposes patients to many conditions that may result in intrathoracic lymphadenopathy presenting the clinician with a diagnostic challenge. 2 Boyton R.J. Infectious lung complications in patients with HIV/AIDS. Curr Opin Pulm Med. 2005; 11: 203-207 PubMed Google Scholar Establishing a definitive diagnosis by tissue biopsy in this setting is important and previously necessitated invasive surgical procedures. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a relatively novel technique developed to allow mediastinal staging of lung cancer by minimally invasive means. Diagnostic yield and complication rate of EBUS-TBNA compare favourably to invasive mediastinoscopy in this setting. 3 Ernst A. Anantham D. Eberhardt R. Krasnik M. Herth F.J. Diagnosis of mediastinal adenopathy-real-time endobronchial ultrasound guided needle aspiration versus mediastinoscopy. J Thorac Oncol. 2008; 3: 577-582 Crossref PubMed Scopus (281) Google Scholar , 4 Rodriguez P. Santana N. Gamez P. Rodríguez de Castro F. Varela de Ugarte A. Freixinet J. Mediastinoscopy in the diagnosis of mediastinal disease. An analysis of 181 explorations. Arch Bronconeumol. 2003; 39: 29-34 Crossref PubMed Google Scholar Efficacy in evaluation of other disease processes such as sarcoidosis and lymphoma has also been established. 5 Kennedy M.P. Jimenez C.A. Bruzzi J.F. Mhatre A.D. Lei X. Giles F.J. et al. Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lymphoma. Thorax. 2008; 63: 360-365 Crossref PubMed Scopus (182) Google Scholar There are currently no data on the use of this technique in HIV-infected patients. We highlight the utility and high diagnostic yield of EBUS-TBNA for the investigation of mediastinal intrathoracic lymphadenopathy in two HIV-infected patients.
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