Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

2015 ◽  
Vol 59 (2) ◽  
pp. 139-143 ◽  
Author(s):  
Ting Qiu ◽  
Hui Zhu ◽  
Min Cai ◽  
Qingbin Han ◽  
Jingyu Shi ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Histological Study ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Predictive Values ◽  
Diagnostic Values ◽  
Liquid Based Cytology ◽  
The Difference

Objective: This study investigated whether liquid-based cytology (LBC) can improve diagnostic values of cytological assessment of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Study Design: A cohort of 600 cases in West China Hospital was prospectively studied from June 2012 to September 2013. EBUS-TBNA was carried out in outpatients under local anesthesia and moderate sedation. The procedure was performed with an echobronchoscope (BF-UC160F-OL8, Olympus, Tokyo, Japan). Histological cores were stained with hematoxylin and eosin for further study. Additional immunohistological analysis was performed for establishing a reliable diagnosis when necessary. Aspirates were smeared on glass slides and separate aspirates were processed by the monolayer SurePath method. Results: In total, 480 malignant tumors and 120 benign lesions were confirmed by histological examination. The sensitivity of SurePath liquid-based preparations and conventional smears was 82.1 and 56%, and the specificity was 87.5 and 82.5%, respectively. The combined specificity was 100%. Positive predictive values of the two groups were 96.3 and 92.8%, whereas negative predictive values were 54.9 and 31.9%, respectively. The difference between the two groups was significant (p < 0.001). Conclusions: LBC preparation can improve cytological assessment of EBUS-TBNA. Histological study is necessary in cases in which the cytological diagnosis is obscure.

Utility of Rapid On-Site Cytologic Evaluation during Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Malignant and Nonmalignant Disease

2018 ◽  
Vol 62 (5-6) ◽  
pp. 380-385 ◽  
Author(s):  
Pietro Gianella ◽  
Paola M. Soccal ◽  
Jérôme Plojoux ◽  
Isabelle Frésard ◽  
Jean-Claude Pache ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Daily Practice ◽  
Needle Aspiration ◽  
Multivariate Model ◽  
Endobronchial Ultrasound ◽  
Moderate Increase ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
The Difference ◽  
The Impact

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an accurate procedure to sample mediastinal tissue. Rapid on-site cytologic evaluation (ROSE) has been advocated to improve the performance of this procedure, but its benefit remains controversial. Our objective is to assess the utility of ROSE for EBUS-TBNA diagnostic accuracy among unselected patients. Methods: We prospectively collected data from all consecutive EBUS-TBNA procedures performed between 2008 and 2014. ROSE was introduced since 2011 in our daily practice. The accuracy of EBUS-TBNA with and without ROSE was compared in a univariate and multivariate model accounting for confounding factors. The impact of ROSE was then analyzed according to the etiology and size of the lesions. Results: Among 348 EBUS-TBNA procedures analyzed, 213 were performed with ROSE. The overall accuracy tended to be better with ROSE than without (90.6 vs. 84.4%; p = 0.082). After adjustment in a multivariate model, the benefit of ROSE still did not reach statistical significance (adjusted odds ratio 1.86; 95% confidence interval 0.79–4.41). Similar results were obtained in subgroups of patients with malignant disease or sarcoidosis. The size of the lesion did not influence the impact of ROSE on accuracy. Conclusions: ROSE was associated with a moderate increase in the accuracy of EBUS-TBNA, but the difference was not statistically significant. The same effect of ROSE was observed in malignant and nonmalignant lesions and this effect was not influenced by the lesion’s size.

scholarly journals Utility of on-site evaluation of endobronchial ultrasound-guided transbronchial needle aspiration specimens

CytoJournal ◽  
2011 ◽  
Vol 8 ◽  
pp. 20 ◽  
Author(s):  
Adrienne Carruth Griffin ◽  
Lauren Ende Schwartz ◽  
Zubair W. Baloch
Keyword(s):  
Clinical Decision Making ◽  
Malignant Tumors ◽  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Cytologic Diagnosis ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an integral tool in the diagnosis and staging of malignant tumors of the lung. Rapid on-site evaluation (ROSE) of fine needle aspiration (FNA) samples has been advocated for as a guide for assessing the accuracy and adequacy of biopsy samples. Although ROSE has proven useful for numerous sites and procedures, few studies have specifically investigated its utility in the assessment of EBUS-TBNA specimens. The intention of this study was to explore the utility of ROSE for EBUS-TBNA specimens. Materials and Methods: The pathology files at our institution were searched for all EBUS-TBNA cases performed between January 2010 and June 2010. The data points included number of sites sampled per patient, location of site(s) sampled, on-site evaluation performed, preliminary on-site diagnosis rendered, final cytologic diagnosis, surgical pathology follow-up, cell blocks, and ancillary studies performed. Results: A total of 294 EBUS-TBNA specimens were reviewed and included in the study; 264 of 294 (90%) were lymph nodes and 30 of 294 (10%) were lung mass lesions. ROSE was performed for 140 of 294 (48%) specimens. The on-site and final diagnoses were concordant in 104 (74%) and discordant in 36 (26%) cases. Diagnostic specimens were obtained in 132 of 140 (94%) cases with on-site evaluation and 138 of 154 (90%) without on-site evaluation. The final cytologic diagnosis was malignant in 60 of 132 (45%) cases with ROSE and 46 of 138 (33%) cases without ROSE, and the final diagnosis was benign in 57 of 132 (47%) with ROSE and 82 of 138 (59%) without ROSE. A cell block was obtained in 129 of 140 (92%) cases with ROSE and 136 of 154 (88%) cases without ROSE. Conclusions: The data demonstrate no remarkable difference in diagnostic yield, the number of sites sampled per patient, or clinical decision making between specimens collected via EBUS-TBNA with or without ROSE. As a result, this study challenges the notion that ROSE is beneficial for the evaluation of EBUS-TBNA specimens.

scholarly journals Purulent Appearing Material in an Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Mediastinal Lymph Node: A Diagnostic Challenge

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Damaris Pena ◽  
Gilda Diaz-Fuentes ◽  
Sindhaghatta Venkatram
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Malignant Tumors ◽  
Mediastinal Lymph Node ◽  
Lung Nodule ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymphadenopathy ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has increasingly been performed for the diagnosis and staging of thoracic malignancies. Findings of a necrotic lymph node raise concern for infectious process and malignancy. A hypoechoic area on ultrasound/EBUS within a lymph node without blood flow is suggestive of pathologies like infections or malignancy. Inspection of the fluid could suggest a diagnosis; clear aspirates usually suggest bronchogenic or mediastinal cysts and purulent material suggests abscesses or necrotic lymph nodes. Growing tumor cells require a blood supply; if the vascular stroma is insufficient due to rapidly growing malignant tumors this could lead to large central areas of ischemic necrosis. Necrotic aspiration of lymph nodes is not always of infectious etiology. Aspiration of fluid in EBUS-TBNA is a rare occurrence, and malignancy should be considered when purulent fluid material is obtained. We present an elderly woman who underwent bronchoscopy with EBUS-TBNA for evaluation of upper lung nodule and mediastinal lymphadenopathy. Pus-like material was obtained on needle aspiration and endobronchial biopsy and mediastinal core biopsy revealed squamous cell carcinoma.

scholarly journals Intimal angiosarcoma of the thoracic aorta diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Liliana Fernández-Trujillo ◽  
Daisy C. Buenaventura ◽  
Luz F. Sua
Keyword(s):  
Thoracic Aorta ◽  
Malignant Tumors ◽  
Main Bronchus ◽  
Needle Aspiration ◽  
Left Main Bronchus ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Left Main ◽  
Transbronchial Needle Aspiration ◽  
First Case

Abstract Background Primary malignant tumors of the aorta are extremely rare. They are frequently located in the abdominal aorta, followed by the thoracic aorta. Sarcomas are the most common histological type. These tumors originate from the middle or intimal layer, the latter being the most common. Symptoms and radiological findings are generally nonspecific. Since their growth is endovascular, embolic phenomena can occur leading to occlusive signs and symptoms. Case presentation We describe the case of a 75-year-old Hispanic man, a former tobacco smoker, with a history of pain and epigastric tenderness, dysphagia, and weight loss of approximately 6 kg. A thorax computed tomography scan showed a mass within the posterior mediastinum with poorly defined borders and heterogeneous density, located between thoracic vertebra 5–8, with a size of 78 × 53 × 76 mm, with left main bronchus compression. Endobronchial ultrasound-guided transbronchial needle aspiration was performed; it found an extrinsic posterior compression of the left main bronchus with no endobronchial injury. An intimal angiosarcoma of the thoracic aorta was diagnosed. Conclusion Tumors of the aorta are rare and difficult to diagnose; they are a challenge during the diagnosis, since they usually require open surgical procedures. Endobronchial ultrasound-guided transbronchial needle aspiration associated with rapid on-site examination offered, in this case, the possibility of a successful diagnosis, avoiding major procedures. This is the first case reported in the literature of an intimal angiosarcoma of the thoracic aorta diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration.

Acute pericarditis and mediastinal lymph node abscess developing after endobronchial ultrasound guided transbronchial needle aspiration

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Shingo Nishikawa ◽  
Ryo Ariyasu ◽  
Tomoaki Sonoda ◽  
Masafumi Saiki ◽  
Takahiro Yoshizawa ◽  
...  
Keyword(s):  
Lymph Node ◽  
Mediastinal Lymph Node ◽  
Tumor Therapy ◽  
Needle Aspiration ◽  
Lymph Node Biopsy ◽  
Endobronchial Ultrasound ◽  
Tumor Treatment ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Acute Pericarditis

A 27-year-old man was diagnosed with inflammatory myofibroblastic tumor, and multiple lymph node and subcutaneous metastases. After several administrations of anti-tumor therapy, he underwent mediastinal lymph node biopsy using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to confirm tumor relapse. Five weeks later, he complained of chest pain, then rapidly developed shock due to acute pericarditis. Although he was treated with antibiotics for anaerobic bacterial infection and cardiac drainage, mediastinal lymph node abscess and pericarditis did not improve. After the surgical procedure, his physical condition dramatically improved and he was treated with another molecularly targeted therapy. Pericarditis associated with EBUS-TBNA is extremely rare. In this case, salvage was achieved by surgical drainage of the lymph node abscess and pericarditis, and long survival was obtained with further administration of anti-tumor treatment.

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