Endobronchial ultrasound and lymphoproliferative disorders: A retrospective study

Seher Iqbal, Zachary S. Depew, Paul J. Kurtin, Anne Marie G. Sykes, Geoffrey B. Johnson, Eric S. Edell, Thomas M. Habermann, Fabien Maldonado

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34 Scopus citations

Abstract

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been shown to have excellent diagnostic performance for mediastinal staging of lung cancer. The utility of EBUS-TBNA for the diagnosis of lymphoproliferative disorders involving the mediastinum or hila, or both, is unclear. Methods: A retrospective analysis was completed of all patients diagnosed with a lymphoproliferative disorder involving the mediastinum or hila, or both, who underwent an EBUS-TBNA within 3 months of the diagnosis. Results: Sixty-five patients with mediastinal or hilar lymph node, or both, involvement of their lymphoproliferative disorder underwent EBUS-TBNA within 3 months of their diagnosis. The initial EBUS-TBNA was nondiagnostic in 34 (52%), 11 were subsequently diagnosed by mediastinoscopy, and the remaining 23 were diagnosed by biopsy of a distant site, with involvement of the mediastinum or hilum assumed from preestablished radiographic criteria. A EBUS-TBNA specimen in 31 patients (48%) was interpreted as consistent with or suspicious for a lymphoproliferative disorder. The overall sensitivity of EBUS-TBNA for establishing a definitive diagnosis was 25 of 65 (38%). The sensitivity was lower for new patients, at 7 of 32 (22%), and better for patients with recurrence, at 18 of 33 (55%). Conclusions: Contrary to previous studies, our findings suggest that EBUS-TBNA does not provide sufficient diagnostic material for accurate lymphoproliferative disorder subtyping in a significant number of patients and performs especially poorly when evaluating new patients. Mediastinoscopy should still be considered as the initial diagnostic procedure of choice when the clinical suspicion for a lymphoproliferative disorder is high, unless the patient is being evaluated for a recurrence of prior disorder.

Original languageEnglish (US)
Pages (from-to)1830-1834
Number of pages5
JournalAnnals of Thoracic Surgery
Volume94
Issue number6
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Iqbal, S., Depew, Z. S., Kurtin, P. J., Sykes, A. M. G., Johnson, G. B., Edell, E. S., Habermann, T. M., & Maldonado, F. (2012). Endobronchial ultrasound and lymphoproliferative disorders: A retrospective study. Annals of Thoracic Surgery, 94(6), 1830-1834. https://doi.org/10.1016/j.athoracsur.2012.08.051