The role of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of hilar and mediastinal lesions

Abstract

Abstract Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been recently introduced as a new technique for sampling the hilar/ mediastinal lesions [lymph node (LN) enlargement or masses] with a potential to improve the diagnostic yield as it allows direct visualization of lesion beyond the tracheobronchial wall allowing real-time sampling. EBUS-TBNA diagnostic yield has been satisfactory for both benign and malignant lesions. Aim To evaluate the utility of convex probe EBUS-TBNA in the diagnosis of hilar and mediastinal lesions (LN enlargement or masses). Patients and methods This is a prospective study in which EBUS-guided TBNA via a real-time ultrasound bronchoscope was used to diagnose 25 patients with mediastinal or hilar LN enlargement or masses. Results EBUS-guided TBNA was performed on 15 patients with enlarged mediastinal/hilar LNs and 11 patients with mediastinal masses, achieving specific diagnosis in 73.3% (11/15) and 81.8% (9/11), respectively. The overall diagnostic yield of EBUS-TBNA was 76% (19/25). Overall sensitivity was 82.6%, specificity 100%, positive predictive value 100%, and negative predictive value 33.33%. EBUS-TBNA procedure had no complications in 76% of cases. Conclusion EBUS-TBNA is a minimally invasive, safe, yet still underutilized diagnostic technique with adequate diagnostic yield. Its nationwide application in the field of diagnostic bronchoscopy should be encouraged.

Keywords

• endobronchial ultrasound-directed transbronchial needle aspiration
• malignancy
• mediastinal lesions
• mediastinal lymph nodes
• sarcoidosis
• tuberculosis