Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies

YALÇIN KARADUMAN, Funda; KILIÇ, Hatice; ŞENTÜRK, Ayşegül; Hezer, Habibe; HASANOĞLU, Hatice Canan

Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies

Ayşegül ŞENTÜRK, (Atatürk Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Hatice KILIÇ, (Atatürk Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Habibe HEZER, (Atatürk Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Funda YALÇIN KARADUMAN, (Atatürk Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Hatice Canan HASANOĞLU (Yıldırım Beyazıt Üniversitesi, Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Turkish Journal of Medical Sciences

1 0

Yıl: 2014 Cilt: 44 Sayı: 6 Sayfa Aralığı: 989 - 995 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies

Öz:

Background/aim: Mediastinal lymphadenopathy is common in extrathoracic malignancies and should not always be considered a metastatic lesion. The purpose of this study is to determine the diagnostic value of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) in patients with extrathoracic malignancies. Materials and methods: This study included 54 consecutive patients with extrathoracic malignancies who had suspected mediastinal metastases and had undergone EBUS-TBNA for diagnosis. Results: Using EBUS-TBNA, 27 of 54 patients (50%) were diagnosed with mediastinal metastases. Among patients with mediastinal metastases, 2 (3.7%) had a sarcoid-like reaction, 5 (9.3%) had tuberculosis, and 17 (31.5%) had reactive lymph nodes. In 3 cases (5.5%), a specific diagnosis could not be determined following EBUS-TBNA. Two patients underwent surgical staging of their mediastinal lymphadenopathy, which allowed the detection of mediastinal metastases in 1 patient and that of reactive lymph nodes in the other. The sensitivity, specificity, negative predictive value, and diagnostic accuracy of EBUS-TBNA for the diagnosis of extrathoracic malignancies were calculated as 93%, 100%, 92.6%, and 96.3%, respectively. Conclusion: EBUS-TBNA is a safe and effective procedure. We should consider whether EBUS-TBNA should be the primary diagnostic tool for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. McLoud TC, Kalisher L, Stark P, Greene R. Intrathoracic lymph node metastasis from extrathoracic neoplasms. Am J Roentgenol 1978; 131: 403407.
2. Peric R, Schuurbiers OC, Veseliç M, Rabe KF, van der Heijden HF, Annema JT. Transesophageal endoscopic ultrasoundguided fine-needle aspiration for the mediastinal staging of extrathoracic tumors: a new perspective. Ann Oncol 2010; 21: 14681471.
3. Heidenreich A, Ravery V. Preoperative imaging in renal cell cancer. World J Urol 2004; 22: 307315.
4. Detterbeck FC, Jantz MA, Wallace M, Vansteenkiste J, Silvestri GA. Invasive mediastinal staging of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007; 132: 202S220S.
5. Sève P, Billotey C, Broussolle C, Dumontet C, Mackey JR. The role of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography in disseminated carcinoma of unknown primary site. Cancer 2007; 15: 292299.
6. Cetinkaya E, Seyhan EC, Ozgul A, Gencoglu A, Ozgul G, Cam E, Kamiloglu E. Efficacy of convex probe endobronchial ultrasound (CP-EBUS) assisted transbronchial needle aspiration for mediastinal staging in non-small cell lung cancer cases with mediastinal lymphadenopathy. Ann Thorac Cardiovasc Surg 2011; 17: 236-242.
7. Herth FJ, Annema JT, Eberhardt R, Yasufuku K, Ernst A, Krasnik M, Rintoul RC. Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer. J Clin Oncol 2008; 26: 33463350.
8. Peric R, Schuurbiers OC, Veseliç M, Rabe KF, van der Heijden HF, Annema JT. Transesophageal endoscopic ultrasoundguided fine-needle aspiration for the mediastinal staging of extrathoracic tumors: a new perspective. Ann Oncol 2010; 21: 14681471.
9. Ercan S, Nichols FC 3rd, Trastek VF, Deschamps C, Allen MS, Miller DL, Schleck CD, Pairolero PC. Prognostic significance of lymph node metastasis found during pulmonary metastasectomy for extrapulmonary carcinoma. Ann Thorac Surg 2004; 77: 17861791.
10. Kramer H, Groen HJ. Current concepts in the mediastinal lymph node staging of non-small cell lung cancer. Ann Surg 2003; 238: 180188.
11. Herth FJ, Ernst A, Eberhardt R, Vilmann P, Dienemann H, Krasnik M. Endobronchial ultrasound guided transbronchial needle aspiration of lymph nodes in the radiologically normal mediastinum. Eur Respir J 2006; 28: 910914.
12. Yasufuku K, Chiyo M, Koh E, Moriya Y, Iyoda A, Sekine Y, Shibuya K, Iizasa T, Fujisawa T. Endobronchial ultrasound guided transbronchial needle aspiration for staging of lung cancer. Lung Cancer 2005; 50: 347354.
13. Yasufuku K, Pierre A, Darling G, de Perrot M, Waddell T, Johnston M, da Cunha Santos G, Geddie W, Boerner S, Le LW et al. A prospective controlled trial of endobronchial ultrasoundguided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer. J Thorac Cardiovasc Surg 2011; 142: 13931400.
14. Herth FJ, Eberhardt R, Krasnik M, Ernst A. Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically and positron emission tomographynormal mediastinum in patients with lung cancer. Chest 2008; 133: 887891.
15. Tournoy KG, Govaerts E, Malfait T, Dooms C. Endobronchial ultrasound-guided transbronchial needle biopsy for M1 staging of extrathoracic malignancies. Ann Oncol 2011; 22: 127 131.
16. Park J, Jang SJ, Park YS, Oh YM, Shim TS, Kim WS, Choi CM. Endobronchial ultrasound-guided transbronchial needle biopsy for diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancy. J Korean Med Sci 2011; 26: 274278.
17. Navani N, Nankivell M, Woolhouse I, Harrison RN, Munavvar M, Oltmanns U, Falzon M, Kocjan G, Rintoul RC, Janes SM. Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of intrathoracic lymphadenopathy in patients with extrathoracic malignancy: a multicenter study. J Thorac Oncol 2011; 6: 15051509.
18. Parmaksız ET, Caglayan B, Salepci B, Comert SS, Kiral N, Fidan A, Sarac G. The utility of endobronchial ultrasoundguided transbronchial needle aspiration in mediastinal or hilar lymph node evaluation in extrathoracic malignancy: Benign or malignant? Ann Thorac Med 2012; 7: 210214.
19. Sanz-Santos J, Cirauqui B, Sanchez E, Andreo F, Serra P, Monso E, Castellà E, Llatjós M, Mesa M, Ruiz-Manzano J et al. Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies. Clin Exp Metastasis 2013; 30: 521528.
20. Craun JB, Banks KP, Clemenshaw MN, Moren RW. Sarcoidlike reaction of neoplasia causing hypermetabolic thoracic adenopathy in setting of extrathoracic malignancy: report of two cases and a review of the differential diagnostic considerations. J Nucl Med Technol 2012; 40: 231235.
21. Trisolini R, Cancellieri A, Patelli M. May sarcoidal reaction and malignant features coexist in regional lymph nodes of non-small cell lung cancer patients? Lung Cancer 2009; 66: 272273.

APA	ŞENTÜRK A, KILIÇ H, Hezer H, YALÇIN KARADUMAN F, HASANOĞLU H (2014). Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. , 989 - 995.
Chicago	ŞENTÜRK Ayşegül,KILIÇ Hatice,Hezer Habibe,YALÇIN KARADUMAN Funda,HASANOĞLU Hatice Canan Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. (2014): 989 - 995.
MLA	ŞENTÜRK Ayşegül,KILIÇ Hatice,Hezer Habibe,YALÇIN KARADUMAN Funda,HASANOĞLU Hatice Canan Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. , 2014, ss.989 - 995.
AMA	ŞENTÜRK A,KILIÇ H,Hezer H,YALÇIN KARADUMAN F,HASANOĞLU H Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. . 2014; 989 - 995.
Vancouver	ŞENTÜRK A,KILIÇ H,Hezer H,YALÇIN KARADUMAN F,HASANOĞLU H Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. . 2014; 989 - 995.
IEEE	ŞENTÜRK A,KILIÇ H,Hezer H,YALÇIN KARADUMAN F,HASANOĞLU H "Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies." , ss.989 - 995, 2014.
ISNAD	ŞENTÜRK, Ayşegül vd. "Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies". (2014), 989-995.

APA	ŞENTÜRK A, KILIÇ H, Hezer H, YALÇIN KARADUMAN F, HASANOĞLU H (2014). Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. Turkish Journal of Medical Sciences, 44(6), 989 - 995.
Chicago	ŞENTÜRK Ayşegül,KILIÇ Hatice,Hezer Habibe,YALÇIN KARADUMAN Funda,HASANOĞLU Hatice Canan Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. Turkish Journal of Medical Sciences 44, no.6 (2014): 989 - 995.
MLA	ŞENTÜRK Ayşegül,KILIÇ Hatice,Hezer Habibe,YALÇIN KARADUMAN Funda,HASANOĞLU Hatice Canan Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. Turkish Journal of Medical Sciences, vol.44, no.6, 2014, ss.989 - 995.
AMA	ŞENTÜRK A,KILIÇ H,Hezer H,YALÇIN KARADUMAN F,HASANOĞLU H Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. Turkish Journal of Medical Sciences. 2014; 44(6): 989 - 995.
Vancouver	ŞENTÜRK A,KILIÇ H,Hezer H,YALÇIN KARADUMAN F,HASANOĞLU H Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies. Turkish Journal of Medical Sciences. 2014; 44(6): 989 - 995.
IEEE	ŞENTÜRK A,KILIÇ H,Hezer H,YALÇIN KARADUMAN F,HASANOĞLU H "Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies." Turkish Journal of Medical Sciences, 44, ss.989 - 995, 2014.
ISNAD	ŞENTÜRK, Ayşegül vd. "Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies". Turkish Journal of Medical Sciences 44/6 (2014), 989-995.