PURPOSE: EBUS-TBNA (Endobronchial ultrasound transbronchial needle aspiration) is a relatively novel technique developed to allow mediastinal staging of lung cancer and evaluate the other intrathoracic lymphadenopathy. In a tuberculosis endemic country, there is always possibility of tuberculosis in a patient with mediastinal lymphadenopathy. Therefore, we investigated the effectiveness of routine culture for tuberculosis from EBUS-TBNA
METHODS: We prospectively performed routine culture for tuberculosis from aspiration or core biopsy of 127 patients who underwent EBUS-TBNA due to mediastinal lymphadenopathy between December 2009 and March 2011. A total of 167 lymph nodes (LNs) were analyzed.
RESULTS: Of 127 patients, 16 (12.6%) and three (2.40%) had known lung cancer and tuberculosis as underlying illnesses. Presumptive diagnoses were malignant lymphadenopathy related with lung cancer in 64 (50.3%), tuberculosis in six (4.7%), and sarcoidosis in seven (5.5%) patients. EBUS-TBNA confirmed malignancy in 91 (54.4%), tuberculosis in five (2.9%), and sarcoidosis in 14 (8.3%) LN stations. Of five patients with tuberculosis, one patient was diagnosed through culture of aspiration, core biopsied tissue and pathologic diagnosis. One patient was diagnosed through culture of aspiration and core biopsied tissue and three patients were diagnosed through only pathologic diagnosis.
CONCLUSIONS: These results suggest that routine culture for tuberculosis from EBUS-TBNA is not additionally useful to diagnose coincidence of tuberculosis with other benign or malignant disease.
CLINICAL IMPLICATIONS: Tuberculosis culture from EBUS-TBNA should be performed if there is any possibility of tuberculosis,but not routinely.
DISCLOSURE: The following authors have nothing to disclose: Ji Young Hong, Su Hwan Lee, Eun Young Kim, Sang Kook Lee, Young Sam Kim, Ji Ye Jung
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