Conventional transbronchial needle aspiration (C-TBNA) is a recognized method for collecting tissue and cell samples through flexible bronchoscopy, but does not allow real-time lymph node vision. The endobronchial ultrasound associated with needle aspiration (EBUS-TBNA) comes preferentially to collect lymph nodes, peribronchial or peritracheal masses.
To describe the results of the application of EBUS-TBNA in the definition of diagnosis in cases of mediastinal lesions due to different causes in a private institution in the city of São Paulo.
Retrospective cross-sectional study of EBUS-biopsied patients. We included all cases referred for collection of lymph nodes or peritracheal and/or peribronchial masses by EBUS-TBNA, between June 2013 and October 2016, studied with CT or PET-CT. All cases were performed by interventional pulmonologists and thoracic surgeons with experience in the procedure. Rapid on-site evaluation (ROSE) of fine needle aspiration (FNA) biopsy was performed in all cases by an experienced pathologist, and the materials were prepared on slides and sent for histopathological analysis and other conditions according to a need.
Mean age was 61.17 (± 14.67) years old and male gender predominated (42-64%). EBUS-TBNA was definitive for diagnosis in 60 cases (91%), 3 (4.5%) were inconclusive and in only 1 (1.5%) the result was false negative. In 2 (3%) cases there was loss of follow-up. There were no complications during or after the procedure.
Figure 1: Representativeness of the material aspirated during EBUS-TBNA.
Figure 2: Diagnoses obtained by EBUS-TBNA.
Figure 3: A) Puncture of lymph nodes by EBUS-TBNA; B) Cytological smears show clusters of atypical epithelial cells in mid-lymphoid fundus; C) Heterogeneous lymph node observed by EBUS; D) Cell block showing histiocytic aggregates sketching granulomas.
In our series, EBUS-TBNA had a high diagnostic yield, with minimal morbidity, constituting an excellent option for patients with lymphadenopathy or intrathoracic expansive lesions.
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