The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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The diagnostic efficacy and safety of endobronchial ultrasound-guided transbronchial needle aspiration as an initial diagnostic tool

  • Choi, Young Rak (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • An, Jin Young (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Kim, Mi Kyeong (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Han, Hye-Suk (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Lee, Ki Hyeong (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Kim, Si-Wook (Department of Thoracic Surgery, Chungbuk National University College of Medicine) ;
  • Lee, Ki Man (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Choe, Kang Hyeon (Department of Internal Medicine, Chungbuk National University College of Medicine)
  • Received : 2012.07.18
  • Accepted : 2013.02.07
  • Published : 2013.11.01
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Abstract

Background/Aims: Real-time, convex probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used for the staging of malignant mediastinal lymph nodes. We evaluated the diagnostic efficacy and safety of EBUS-TBNA when used as an initial diagnostic tool. Methods: We retrospectively studied 56 patients who underwent EBUS-TBNA as an initial diagnostic tool between August 2010 and December 2011. Procedure purpose were classified into four categories: 1) intrathoracic masses adjacent to the central airway; 2) enlarged lymph nodes for concurrent diagnosis and staging in suspected malignancy; 3) enlarged lymph nodes in suspected malignancy cases with inability to perform percutaneous core needle biopsy (PCNB); and 4) solely mediastinal masses/lymph nodes in lieu of mediastinoscopy. Results: The diagnostic accuracy of EBUS-TBNA regardless of procedure purpose was calculated to be 83.9%. Furthermore, the diagnostic accuracy of malignant disease was significantly higher than benign disease (93.9% vs. 70.6%, p < 0.001). The diagnostic accuracy of EBUS-TBNA for each disease is as follows: tuberculosis, 50%; sarcoidosis, 60%; aspergillosis, 100%; lung abscess, 100%; lung cancer, 93%; and lymphoma, 100%. There were minor complications in seven patients during the EBUS-TBNA procedure. The complications included mild hypoxia and bleeding. Conclusions: In conclusion, EBUS-TBNA is a useful initial diagnostic tool for both benign and malignant diseases. EBUS-TBAN is also a very safe procedure and less invasive compared to mediastinoscopy or PCNB.

Keywords

References

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