Kanda Hideki, Uchimura Keigo, Hara Sachika, Sakakibara Hideki, Morimoto Toshiki, Shigemi Saki, Nakamura Kei, Hashimoto Kohei, Iwanaga Yuto, Yamaguchi Yudai, Miyata Emiko, Ikushima Issei, Tachiwada Takashi, Yamasaki Kei, Kawanami Toshinori, Yatera Kazuhiro
Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2020;42(2):223-227. doi: 10.7888/juoeh.42.223.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been reported to be useful not only for the diagnosis of lymph node metastasis of lung cancer but also for benign diseases. We retrospectively analyzed the results of patients with tuberculous lymphadenitis (TL) who had undergone EBUS-TBNA between November 2010 and January 2016. EBUS-TBNA was performed in 427 cases during that period. Six cases were finally diagnosed as TL. The punctured lymph node was 8 lesions. Pathological findings consistent with TL were obtained in all 6 cases (100%), and the tissue specimens were positive in Ziehl-Neelsen staining in 3 of the 6 cases (50%). In all 6 cases, the acid-fast bacteria (AFB) smear test of the needle rinse fluid was negative, 2 cases were positive for AFB culture (33.3%), and 2 cases were positive for Mycobacterium tuberculosis (MTB)-PCR test (33.3%). In this study, the positive rate of mycobacterial culture and the MTB-PCR test of the needle rinse fluid was low, though the concordance rate of pathological findings with TL was high (100%). The results suggest that EBUS-TBNA should be carefully evaluated in patients with TL, considering the low positive rate of mycobacterial culture and MTB-PCR test in the needle rinse fluid.
据报道，支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）不仅对肺癌淋巴结转移的诊断有用，对良性疾病也有用。我们回顾性分析了2010年11月至2016年1月期间接受EBUS-TBNA的结核性淋巴结炎（TL）患者的结果。在此期间共进行了427例EBUS-TBNA。最终确诊为TL的有6例。穿刺淋巴结共8个病灶。6例患者（100%）均获得了与TL一致的病理结果，6例中有3例（50%）组织标本齐-尼氏染色呈阳性。6例患者针冲洗液的抗酸杆菌（AFB）涂片检查均为阴性，2例AFB培养阳性（33.3%），2例结核分枝杆菌（MTB）-PCR检测阳性（33.3%）。在本研究中，尽管病理结果与TL的符合率较高（100%），但针冲洗液的分枝杆菌培养和MTB-PCR检测的阳性率较低。结果表明，考虑到针冲洗液中分枝杆菌培养和MTB-PCR检测的阳性率较低，对于TL患者应谨慎评估EBUS-TBNA。
