Abstract
Mediastinal lymphadenopathy is a condition in which one or more mediastinal lymph nodes are enlarged for malignant or benign causes, generally more than 10 mm. For a long time, the only way to approach the mediastinum was surgery, while in last decades endoscopic techniques gained their role in neoplastic diseases. At the present time, EBUS is the technique of choice for studying the mediastinum in the suspicion of cancer, while there are not strong indications in guidelines for the study of benign mediastinal lymphadenopathy. We reviewed the literature, looking for evidence of the role of EBUS in the diagnostics of non-neoplastic mediastinal lymphadenopathy, with special regard for granulomatous disease, both infectious and non-infectious. EBUS is a reliable alternative to surgery in non-neoplastic mediastinal lymphadenopathy, even if more evidence is needed for granulomatous diseases other than tuberculosis and sarcoidosis.
Highlights
The term “lymphadenopathy” refers to a condition in which one or more lymph nodes are enlarged for a known or unknown cause, generally for the hyperplasia of one or more cell types [1]
Endoscopic mediastinal procedures using ultrasound are represented by endoscopic ultrasound (EUS) and endobronchial ultrasound (EBUS) [2]
Mediastinal lymph nodes’ alterations may be due to benign diseases, including infectious or inflammatory diseases such as tuberculosis or sarcoidosis, which are the principal causes
Summary
The term “lymphadenopathy” refers to a condition in which one or more lymph nodes are enlarged for a known or unknown cause, generally for the hyperplasia of one or more cell types [1]. Studying mediastinal lymph nodes has always been challenging because of their position and the relative difficulty in reaching the mediastinal structure. The main aims in studying mediastinal lymph nodes are the diagnosis and staging of malignancies, especially lymphomas and non-small cell lung cancer (NSCLCs), as well as metastases from other organs’ tumours (oesophago-gastric cancer [4,5], thyroid cancer [6], seminoma [7], breast cancer [8]). The purpose of the present review is to examine the role and the diagnostic yield of endobronchial ultrasound in studying benign mediastinal lymphadenopathy
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