Author of

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  P1.05 - Interventional Diagnostics/Pulmonology (Not CME Accredited Session) (ID 937)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

  • 26485

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    P1.05-11 - Role of EBUS-TBNA in Evaluation of Mediastinal Lymphadenopathy and Masses in Patients with Known or Suspected Extra-Pulmonary Malignancies (ID 11907)

    16:45 - 18:00  |  Author(s): Aruna Nambirajan
    • Abstract
    • Slides

    Background
    

    Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has recently emerged as a minimally invasive and safe modality for the evaluation of mediastinal lymphadenopathy, particularly in staging of lung carcinoma patients. Our aim was to evaluate its utility in patients with non-pulmonary malignancies presenting with mediastinal lymphadenopathy.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    A computerized database search was performed for all EBUS-TBNA aspirations performed from 2015 to 2017 on patients with known or suspected extra-pulmonary malignancy and presence of mediastinal lymphadenopathy and/or masses on imaging. All archived cytology material was reviewed and categorized as positive, negative and unsatisfactory. Follow-up histology samples served as comparison standard.

    4c3880bb027f159e801041b1021e88e8 Result
    

    One-hundred-twenty-one patients were included. In 99 patients with known malignancy, primary sites were in the head and neck (25%), breast (22%), female genital tract (9%), lower gastrointestinal (GI)-tract (8%), genitourinary tract (7%), and upper GI-tract (5%). Six patients had history of hematolymphoid malignancy while primary site or type of malignancy was unknown in the remaining (18%). EBUS-TBNA diagnosed metastases or lymphoma relapse in 48 (40%), identified new malignancy in 18 (15%), granulomatous inflammation in 15 (12%), tuberculosis in 2 (1%), reactive lymphadenitis in 21 (17%) patients and was inadequate in 17 (14%) patients. Cell block was adequate in 43% (23/53) cases and was indispensible for diagnosis in 13% (7/53) cases. Subcarinal and right paratracheal lymphnodes were most commonly aspirated (77%) while hilar and paratracheal masses of non-lymphnode origin were assessed in 10% cases. Follow-up histology samples (available only in 13 cases) showed 100% concordance with EBUS-TBNA results (no false positive or false negative cases). Two cases unsatisfactory on EBUS-TBNA were positive for malignancy on histology.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    EBUS-TBNA is a highly efficient modality for the evaluation of mediastinal lymphnodes and masses in patients with extra-pulmonary malignancies with an overall diagnostic yield of 86%.

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