Endobronchial ultrasound and lymphoproliferative disorders: A retrospective study

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

Research output: Contribution to journalArticle

31 Citations (Scopus)

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

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Lymphoproliferative Disorders
Needles
Retrospective Studies
Mediastinum
Mediastinoscopy
Recurrence
Lung Neoplasms
Lymph Nodes
Biopsy

All Science Journal Classification (ASJC) codes

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

Cite this

Iqbal, S., Depew, Z., Kurtin, P. J., Sykes, A. M. G., Johnson, G. B., Edell, E. S., ... 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

Endobronchial ultrasound and lymphoproliferative disorders : A retrospective study. / Iqbal, Seher; Depew, Zachary; Kurtin, Paul J.; Sykes, Anne Marie G; Johnson, Geoffrey B.; Edell, Eric S.; Habermann, Thomas M.; Maldonado, Fabien.

In: Annals of Thoracic Surgery, Vol. 94, No. 6, 12.2012, p. 1830-1834.

Research output: Contribution to journalArticle

Iqbal, S, Depew, Z, Kurtin, PJ, Sykes, AMG, Johnson, GB, Edell, ES, Habermann, TM & Maldonado, F 2012, 'Endobronchial ultrasound and lymphoproliferative disorders: A retrospective study', Annals of Thoracic Surgery, vol. 94, no. 6, pp. 1830-1834. https://doi.org/10.1016/j.athoracsur.2012.08.051
Iqbal, Seher ; Depew, Zachary ; Kurtin, Paul J. ; Sykes, Anne Marie G ; Johnson, Geoffrey B. ; Edell, Eric S. ; Habermann, Thomas M. ; Maldonado, Fabien. / Endobronchial ultrasound and lymphoproliferative disorders : A retrospective study. In: Annals of Thoracic Surgery. 2012 ; Vol. 94, No. 6. pp. 1830-1834.
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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.",
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