Dhamija Amit, Basu Arup, Sharma Vishal, Bakshi Pooja, Verma Kusum
Consultant.
Sr. Consultant, Dept. of Chest Medicine, Sir Ganga Ram Hospital, New Delhi.
J Assoc Physicians India. 2015 Sep;63(9):15-8.
Aetiology of mediastinal adenopathy is likely to vary with geographic location and socioeconomic status of a population. Whilst most of adenopathy in the West could be attributed to malignant disorders, causes of the same in a developing country like India has not been extensively studied earlier due to lack of less invasive tools to sample these nodes for cytological and microbiological analysis. Endobronchial ultrasound (EBUS) helps us reach these nodes as a minimally invasive procedure to take aspirations under real-time ultrasound guidance. The aim of the present study is to study the aetiology of mediastinal adenopathy in our population with the help of EBUS.
This was a retrospective analysis of all EBUS procedures done by the authors and the diagnosis thus obtained at Sir Ganga Ram Hospital, New Delhi, India between April 2010 and December 2011.
A total of 300 patients underwent EBUS in the above period. Most common aetiology encountered in our population was a granulomatous disorder (53% cases) like tuberculosis and sarcoidosis whilst malignancy was third in order of diagnosis (17% cases). Lymph node enlargement due to anthracosis was another uncommon aetiology encountered in the study (5% cases).
Benign granulomatous disorders like tuberculosis and sarcoidosis are the most common causes of mediastinal adenopathy in our population. EBUS is proving its worth for diagnosing mediastinal adenopathy.
纵隔淋巴结肿大的病因可能因人群的地理位置和社会经济状况而异。在西方,大多数淋巴结肿大可归因于恶性疾病,而在印度这样的发展中国家,由于缺乏用于对这些淋巴结进行细胞学和微生物学分析的微创采样工具,此前尚未对其病因进行广泛研究。支气管内超声(EBUS)作为一种微创手术,可在实时超声引导下穿刺取材,帮助我们获取这些淋巴结。本研究的目的是借助EBUS研究我国人群纵隔淋巴结肿大的病因。
这是一项对作者在印度新德里甘加拉姆爵士医院于2010年4月至2011年12月期间进行的所有EBUS手术及由此获得的诊断结果的回顾性分析。
在此期间共有300例患者接受了EBUS检查。我国人群中最常见的病因是肉芽肿性疾病(53%的病例),如结核病和结节病,而恶性肿瘤在诊断顺序中位列第三(17%的病例)。煤尘肺导致的淋巴结肿大是本研究中遇到的另一种不常见病因(5%的病例)。
结核病和结节病等良性肉芽肿性疾病是我国人群纵隔淋巴结肿大的最常见原因。EBUS在诊断纵隔淋巴结肿大方面正证明其价值。