THE ROLE OF ENDOBRONCHIAL ULTRASOUND IN THE DIAGNOSIS OF MALIGN AND BENING LUNG DISEASES CAUSING MEDIASTINAL LYMPHADENOPATHY
Project no. 129 · Status: Kapanmış · 2017
Summary
Endobronchial ultrasonography (EBUS) guided transbronchial needle aspiration (TBNA) is primarily used in the diagnosis and staging of lung cancer. However, in recent years, it has been widely used in the diagnosis of benign diseases as well as malignant lung diseases. The aim of this study is to investigate the diagnostic effectiveness and reliability of EBUS in the diagnosis of benign and malignant lung diseases that cause mediastinal and hilar lymphadenopathy. Pathological lymph nodes observed in thorax computed tomography (CT) or positron emission tomography (PET) were evaluated and patients with EBUS-TBNA indication were included in the study. A definitive diagnosis was made in 50% of 248 patients who had mediastinal and hilar lymph node sampling with EBUS-TBNA, lymph node sampling was evaluated as benign in 44%, and lymph node sampling was considered insufficient in 6% of the patients. The most frequently sampled lymph nodes were the lymph nodes at stations 7 and 4R. While the diagnosis of granulomatous inflammation most often obtained from the lymph node sampling at station 7, the diagnosis of lung cancer was made mostly from the lymph node sampling at station 4R. 31 patients diagnosed with granulomatous inflammation were found to be younger and more female compared to other diagnostic groups, and 29 of the patients were evaluated as sarcoidosis. While the diagnosis of lung cancer was made in 77 patients with EBUS-TBNA, it was observed that a total of 82 patients were diagnosed with lung cancer, considering the final diagnosis. Considering the final diagnosis, the sensitivity of EBUS-TBNA in diagnosing lung cancer was evaluated as 93.9% and specificity as 100%. During the study period, no life-threatening complications were observed in any patient during or after the EBUS-TBNA procedure. In conclusion, EBUS-TBNA is an effective and reliable method in elucidating the etiology of mediastinal and hilar lymph nodes.