Korrungruang Potjanee, Oki Masahide, Saka Hideo, Kogure Yoshihito, Tsuboi Rie, Oka Saori, Nakahata Masashi, Hori Kazumi, Murakami Yasushi, Ise Yuko, Ahmed Shimaa Nour Moursi, Kitagawa Chiyoe
Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan; Respiratory Unit, Department of Medicine, Rajavithi Hospital, Bangkok, Thailand.
Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan.
Respir Investig. 2016 Jan;54(1):29-34. doi: 10.1016/j.resinv.2015.07.003. Epub 2015 Sep 11.
The usefulness of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for evaluating hilar, mediastinal and central parenchymal lesions has been well established. However, its utility for diagnosing lymphoma is controversial. The aim of this study was to evaluate the diagnostic utility of EBUS-TBNA for the definitive diagnosis of de novo lymphoma with subtype classification.
Patients with lymphoma who underwent EBUS-TBNA for diagnostic purposes at a single institution between March 2004 and May 2013 were retrospectively reviewed.
Of the 971 patients who underwent EBUS-TBNA during the study period, 19 patients, who did not have a previous history of lymphoma, had a final diagnosis of lymphoma. EBUS-TBNA provided a diagnosis accompanied with subtype classification in 6 patients (32%), a suspicious but not definitive classification in 10 patients (53%), and a negative classification in 3 patients (16%). Immunohistochemical staining for definitive diagnosis was performed in 15 of 16 patients (94%), with suspicious results from routine hematoxylin and eosin staining. No procedure-related complications occurred.
EBUS-TBNA is a useful initial diagnostic procedure, aiding decisions for the management of patients with suspected lymphoma, even though the sensitivity of EBUS-TBNA for diagnosing lymphoma with subtype classification was lower than previously reported.
支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）在评估肺门、纵隔及中央实质病变方面的有效性已得到充分证实。然而，其在淋巴瘤诊断中的效用仍存在争议。本研究旨在评估EBUS-TBNA对初发淋巴瘤进行确诊及亚型分类的诊断效用。
回顾性分析2004年3月至2013年5月期间在单一机构因诊断目的接受EBUS-TBNA检查的淋巴瘤患者。
在研究期间接受EBUS-TBNA检查的971例患者中，19例既往无淋巴瘤病史的患者最终被诊断为淋巴瘤。EBUS-TBNA对6例患者（32%）做出了伴有亚型分类的诊断，对10例患者（53%）做出了可疑但不明确的分类，对3例患者（16%）做出了阴性分类。16例患者中有15例（94%）进行了用于确诊的免疫组化染色，其常规苏木精和伊红染色结果可疑。未发生与操作相关的并发症。
EBUS-TBNA是一种有用的初始诊断方法，有助于对疑似淋巴瘤患者的管理做出决策，尽管EBUS-TBNA对淋巴瘤进行亚型分类诊断的敏感性低于先前报道。
