EBUS-TBNA in the differential diagnosis of tuberculous lymphadenitis in patients with mediastinal lymphadenopathy

Abstract

This paper presents the results of the prospective study of transbronchial aspiration of mediastinal lymph nodes under the control of ultrasound (EBUS-TBNA) in the diffe- rential diagnosis of tuberculous lymphadenitis in patients with mediastinal lymphadenopathy. From March 2010 to February 2013 in this study 72 patients with mediastinal lymphadenopathy of unknown etiology, suspected tu- berculosis were enrolled. Methods: EBUS-TBNA followed by VATS biopsy of mediastinal lymph nodes. The dura- tion of EBUS-TBNA was 31.1 + 4.9 min. Complications after the procedure were not observed. The sensitivity of the morphological method of TB diagnosis was 30%,molecular diagnostic methods was 60%. The overall sen- sitivity of transbronchial aspiration under the control of ultrasound for the diagnosis of tuberculosis was 70%, specificity - 98%, positive predictive value and negative results, accuracy - 87.5, 94.6, 93.7%, respectively. The comprehensive study transbronchial aspirates obtained by EBUS-TBNA, with high accuracy to eliminate the tuber- culosis, as cause of lymphadenopathy. EBUS-TBNA in the diagnostic algorithms may allow reducing the number of diagnostic operations almost doubled in patients with lymphadenopathy mediastinum.