Department of Pulmonary Disease, Atatürk Training and Research Hospital, Ankara, Turkey.
Turk J Med Sci. 2014;44(6):989-95. doi: 10.3906/sag-1309-127.
BACKGROUND/AIM: Mediastinal lymphadenopathy is common in extrathoracic malignancies and should not always be considered a metastatic lesion. The purpose of this study is to determine the diagnostic value of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) in patients with extrathoracic malignancies.
This study included 54 consecutive patients with extrathoracic malignancies who had suspected mediastinal metastases and had undergone EBUS-TBNA for diagnosis.
Using EBUS-TBNA, 27 of 54 patients (50%) were diagnosed with mediastinal metastases. Among patients with mediastinal metastases, 2 (3.7%) had a sarcoid-like reaction, 5 (9.3%) had tuberculosis, and 17 (31.5%) had reactive lymph nodes. In 3 cases (5.5%), a specific diagnosis could not be determined following EBUS-TBNA. Two patients underwent surgical staging of their mediastinal lymphadenopathy, which allowed the detection of mediastinal metastases in 1 patient and that of reactive lymph nodes in the other. The sensitivity, specificity, negative predictive value, and diagnostic accuracy of EBUS-TBNA for the diagnosis of extrathoracic malignancies were calculated as 93%, 100%, 92.6%, and 96.3%, respectively.
EBUS-TBNA is a safe and effective procedure. We should consider whether EBUS-TBNA should be the primary diagnostic tool for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies.
背景/目的：纵隔淋巴结病在胸外恶性肿瘤中很常见，不应总是被视为转移病灶。本研究旨在确定经支气管超声引导针吸活检（EBUS-TBNA）在胸外恶性肿瘤患者中的诊断价值。
本研究纳入了 54 例经胸部 CT 检查怀疑纵隔转移且接受 EBUS-TBNA 诊断的胸外恶性肿瘤患者。
采用 EBUS-TBNA 诊断 54 例患者中有 27 例（50%）存在纵隔转移。纵隔转移患者中，2 例（3.7%）为类肉瘤样反应，5 例（9.3%）为结核，17 例（31.5%）为反应性淋巴结。在 3 例（5.5%）中，EBUS-TBNA 后无法确定明确诊断。2 例患者接受纵隔淋巴结分期手术，其中 1 例发现纵隔转移，另 1 例发现反应性淋巴结。EBUS-TBNA 诊断胸外恶性肿瘤的灵敏度、特异性、阴性预测值和诊断准确性分别为 93%、100%、92.6%和 96.3%。
EBUS-TBNA 是一种安全有效的方法。对于胸外恶性肿瘤患者的纵隔淋巴结病，我们应考虑是否应将 EBUS-TBNA 作为主要的诊断工具。
