PURPOSE: The purpose of the current study was to investigate the clinical utility of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal masses in the absence of known pulmonary malignancy.
METHODS: 108 patients with mediastinal masses of unknown origin were included in the study. The convex probe EBUS (Olympus, Japan) integrated with a convex scanning probe on its tip was used for EBUS-TBNA. Final diagnoses were determined by EBUS-TBNA, surgery and/or clinical follow-up. EBUS-TBNA results were classified into 2 categories: (1) malignant mediastinal and (2) benign mediastinal.
RESULTS: The mean age of the group was 56.7 years. The final diagnosis was available in all 108 patients by means of EBUS-TBNA, surgery, mediastinoscopy, other diagnostic or long term follow up. The final diagnoses were 32 malignant mediastinal (12 malignant lymphoma, 5 adenocarcinoma of unknown primary, 4 metastatic, 6 lung cancer, 2 thymic cancer, 1 thymoma, 1 germ cell tumor, 1 chondrosarcoma) and 76 benign mediastinal (38 sarcoidosis, 17 mediastinal cyst, 5 mediastinal goiter, 1 neurogenic tumor, 1 tuberculosis, 1 amyloidosis, 13 nonspecific inflammatory). EBUS-TBNA was diagnostic in 99 of 108 patients (91.7%) for all disease categories (malignant 84.4%, benign 94.7%). EBUS-TBNA was successful in directing subsequent workup and/or therapy in 74 of 108 patients (68.5%).EBUS-TBNA was uneventful and there were no complications.
CONCLUSION: The diagnostic yield of EBUS-TBNA in the assessment of mediastinal masses of unknown origin is very high. There were no complications associated with the procedure. It spares more invasive procedures for tissue sampling of the mediastinum.
CLINICAL IMPLICATIONS: EBUS-TBNA is a safe and minimally invasive approach for sampling of mediastinal tissues. It spares invasive procedures for tissue sampling of the mediastinum which is beneficial for patients with mediastinal masses of unknown origin.
DISCLOSURE: Kazuhiro Yasufuku, No Financial Disclosure Information; No Product/Research Disclosure Information