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联合经支气管针吸活检(TBNA)及快速现场细胞学评估(ROSE)诊断结核性纵隔淋巴结炎:一例报告

Combined transbronchoscopic needle aspiration (TBNA) and rapid on-site cytological evaluation (ROSE) for diagnosis of tuberculous mediastinal lymphadenitis: A case report.

作者信息

Dai Xi, Niu Bin, Yang Xiao-Qiong, Li Guo-Ping

机构信息

Department of Respiratory Medicine, Affiliated Hospital of Southwest Medical University, Luzhou Department of Respiratory Medicine, The Third People's Hospital of Chengdu/Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China.

出版信息

Medicine (Baltimore). 2018 Sep;97(37):e11724. doi: 10.1097/MD.0000000000011724.

Abstract

INTRODUCTION

The diagnosis of tuberculous mediastinal lymphadenitis remains a challenge, and the use of transbronchoscopic needle aspiration (TBNA) combined with rapid on-site cytological evaluation (ROSE) is still unclear. A case of tuberculous mediastinal lymphadenitis was illustrated to show the diagnostic value of TBNA and ROSE.

CASE PRESENTATION

In this case report, we presented a typical case of a 44-year-old male who underwent obvious odynophagia and mild symptom of dyspnea. One isolated mass positioned on posterior mediastinum was examined as positive discovery. Finally, he was diagnosed with tuberculous mediastinal lymphadenitis by using TBNA combined with ROSE and treated with anti-TB.

CONCLUSIONS

TBNA is an efficacious and safe approach, which is worth popularizing for the clinical diagnosis of mediastinal masses. Meanwhile, ROSE is useful to reduce the numbers of needle passes during TBNA. We aimed to emphasize 2 key points in this case report. Firstly, a rare symptom of Tuberculosis in adults was supported by the patient. Secondly, TBNA combined with ROSE is useful for the diagnosis of tuberculous mediastinal lymphadenitis.

摘要

引言

结核性纵隔淋巴结炎的诊断仍然是一项挑战,经支气管针吸活检(TBNA)联合快速现场细胞学评估(ROSE)的应用仍不明确。本文通过一例结核性纵隔淋巴结炎病例展示了TBNA和ROSE的诊断价值。

病例报告

在本病例报告中,我们呈现了一名44岁男性的典型病例,该患者有明显的吞咽痛和轻度呼吸困难症状。在后纵隔发现一个孤立肿块,检查结果为阳性。最终,通过TBNA联合ROSE诊断为结核性纵隔淋巴结炎,并给予抗结核治疗。

结论

TBNA是一种有效且安全的方法,对于纵隔肿块的临床诊断值得推广。同时,ROSE有助于减少TBNA过程中的穿刺次数。我们旨在强调本病例报告中的两个关键点。首先,该患者表现出成人结核病的罕见症状。其次,TBNA联合ROSE对结核性纵隔淋巴结炎的诊断有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5717/6156002/8dd211c777a0/medi-97-e11724-g001.jpg

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