EBUS-TBNA is useful for the clinical diagnosing in patients with mediastinal and/or hilar lymphadenopathy. However, a few cases could not be diagnosed due to the presence of bronchial cartilage. A new technique (Outer Sheath Method; OSM) avoided puncturing the bronchial cartilage, using an outer plastic sheath pressed against to the bronchial wall. Then, the sheath is moved along the wall to locate the most suitable puncture site between the cartilaginous rings. After the suitable site was decided, adequate puncture was performed. We assessed OSM contribute to the diagnostic yield of patients with mediastinal and/or hilar lymphadenopathy.
Between September 2006 and May 2007, we performed EBUS-TBNA without OSM in 32 patients; age 29–82 (mean. 65.0), Male 23, Female 9 (group A). On the other hand, between August 2008 and March 2009 EBUS-TBNA was performed under OSM in 32 different patients; age 33–77 (mean. 61.2), Male 18, Female 14 (group B). Patients with enlarged mediastinal and/or hilar lymph nodes underwent EBUS-TBNA. The bronchoscope was equipped with a 7.5 MHz convex transducer at the tip of a flexible bronchoscope (BF-UC 160F-OL8, Olympus, Tokyo, Japan).
For group A, 29 of 32 patients were available for analysis, excluding 3 cases undiagnosed previously. The sensitivity, specificity, and diagnostic accuracy rate of EBUS-TBNA for diagnosis were 86.3%, 100%, 89.6%, respectively in group A. In group B, 28 of 32 patients were analyzed after excluding 4 patients undiagnosed previously. The sensitivity, specificity, and diagnostic accuracy rate were 95.2%, 100%, 96.4%, respectively. On 4 cases in group A, specimens of bronchial cartilage was obtained. There were no cases in group B. The diagnostic yield of EBUS-TBNA improved using OSM.
This new technique of EBUS-TBNA was useful for clinical diagnosis in patients with mediastinal and/or hilar lymphadenopathy.
A new technique (Outer Sheath Method; OSM) for Endobronchial Ultrasound Guided Transbronchial Needle Aspiration for improving the diagnostic yield in Patients with Mediastinal and/or Hilar Lymphadenopathy.
Takeo Inoue, No Financial Disclosure Information; No Product/Research Disclosure Information