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Kemal Can Tertemiz, Aylin Ozgen Alpaydin, Volkan Karacam
INTRODUCTION: Many extrathoracic malignancies can metastasize to lungs and mediastinal lymph nodes. Whether mediastinal lesions are metastasis in these patients changes staging, prognosis, and treatment strategy. In this study, we aimed to find out the contribution of EBUS-TBNA to the diagnosis in cases with extrathoracic malignancy. MATERIALS AND METHODS: Patients who had been previously diagnosed as extrapulmonary solid organ malignancy and in whom mediastinal or hilar lymphadenopathy developed during their follow-up and EBUS-TBNA was applied for diagnostic purposes were retrospectively included in this study...
October 21, 2016: Surgical Endoscopy
Eric L Scholten, Roy Semaan, Peter Illei, Christopher Mallow, Sixto Arias, David Feller-Kopman, Karen Oakjones-Burgess, Bernice Frimpong, Ricardo Ortiz, Hans Lee, Lonny Yarmus
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of thoracic structures is a commonly performed tissue sampling technique. The usage of an inner-stylet in the EBUS needle has never been rigorously evaluated, and may be unnecessary. METHODS: In a prospective randomized single blinded controlled clinical trial, patients with a clinical indication for EBUS-TBNA underwent lymph node sampling using both with-stylet and without-stylet techniques...
October 18, 2016: Chest
Viboon Boonsarngsuk, Siriwan Saengsri, Pitak Santanirand
BACKGROUND: Intrathoracic tuberculous (TB) lymphadenitis is a diagnostic challenge to the clinician. Although endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can obtain a sample from the affected lymph node, the diagnosis of TB lymphadenitis by cytopathology remains inaccurate. OBJECTIVE: To evaluate the efficacy of EBUS-TBNA rinse fluid TB polymerase chain reaction (PCR) assay for the diagnosis of intrathoracic TB lymphadenitis. METHODS: A retrospective study was conducted on 102 patients who underwent EBUS-TBNA for diagnostic evaluation of intrathoracic lymphadenopathy...
October 21, 2016: Infectious Diseases
Sahajal Dhooria, Nalini Gupta, Amanjit Bal, Inderpaul Singh Sehgal, Ashutosh Nath Aggarwal, Sunil Sethi, Digambar Behera, Ritesh Agarwal
BACKGROUND: In patients with intrathoracic lymphadenopathy, differentiating tuberculosis from sarcoidosis is often difficult. We hypothesized that Xpert MTB/RIF assay, a semi-automated hemi-nested PCR would help in this regard. OBJECTIVE: To evaluate the performance of Xpert MTB/RIF in the differential diagnosis of tuberculosis and sarcoidosis. METHODS: This was a retrospective analysis of patients with intrathoracic lymphadenopathy who underwent endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA), and were diagnosed as either tuberculosis or sarcoidosis...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Cai-Hua Wang, Chuan-Cai Xu, Jun-Hong Jiang, Yan-Bin Chen, Sheng-Hua Zhan
Primary pulmonary synovial sarcoma (PPSS) is a rare disease. Diagnosis is made postoperatively following resection of the tumor. We describe the case of a 39-year-old non-smoking woman whose chest imaging revealed a heterogeneous mass (5.4 cm × 4.6 cm), with soft tissue density in the right upper lobe and pleural effusion in the right hemithorax. The tumor was enhanced on a computed tomography scan, in which enlargement of the mediastinal lymph nodes compressing the adjacent superior vena cava was observed...
September 10, 2016: Thoracic Cancer
Emily Hopkins, David Moffat, Ian Parkinson, Peter Robinson, Hubertus Jersmann, Brendan Dougherty, Mohammed I Birader, Kate Francis, Phan Nguyen
BACKGROUND: Rapid on site examination (ROSE) is encouraged at endobronchial ultrasound transbronchial needles aspiration (EBUS-TBNA) to improve diagnostic yield. Due to new therapeutic options in lung cancer, it is not sufficient to merely distinguish between non-small cell lung carcinoma (NSCLC) and small cell lung carcinoma (SCLC). Immunohistochemistry (IHC) distinction is now standard practice, as well as additional molecular testing where clinically indicated. We investigated the diagnostic yield of on-site smears vs...
September 2016: Journal of Thoracic Disease
Fumihiro Tanaka, Seiki Hasegawa, Nobuyuki Kondo, Ryo Miyahara, Hiroshi Date, Shinji Atagi, Masaaki Kawahara, Takeharu Yamanaka, Toshiaki Manabe, Hiromi Wada
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure for the pathological evaluation of the mediastinal nodal (N2) status of lung cancer; however, its feasibility in potentially operable patients with suspicion of minimal N2 disease remains unestablished. PATIENTS AND METHODS: A prospective multicenter study was conducted to assess the feasibility of EBUS-TBNA in this setting. Patients with clinical stage IIIA-N2 non-small cell lung cancer (NSCLC) and mediastinal nodal enlargement on computed tomography (CT) were eligible; patients were ineligible when CT revealed bulky (> 3 cm in the long-axis diameter) N2 or multiple (≥ 3) station N2...
2016: Oncology Research and Treatment
Ayperi Ozturk, Nilgun Yilmaz Demirci, Zafer Aktas, Funda Demirag, Ali Alagoz, İbrahim Onur Alici, Aydın Yilmaz
BACKGROUND: Small cell lung cancer (SCLC) commonly presents as hilar/mediastinal masses. In some occasions, conventional flexible bronchoscopy fails and a substantial amount of time is lost until establishing the diagnosis. OBJECTIVE: The aim of the study was to demonstrate the superiority of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) compared to conventional methods in establishing the diagnosis as an initial modality as well as to point out the saved time until the diagnosis...
September 22, 2016: Clinical Respiratory Journal
Hyo Jae Kang, Bin Hwangbo, Jin Soo Lee, Moon Soo Kim, Jong Mog Lee, Geon-Kook Lee
INTRODUCTION: Although the use of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is increasing for epidermal growth factor receptor (EGFR) testing in lung cancer, the discordance rate in EGFR mutations between lymph node (LN) samples obtained by EBUS-TBNA and primary tumor (PT) is not well known. Thus, we compared the EGFR mutation status of LN samples obtained by EBUS-TBNA and PTs to estimate the efficacy of using EBUS-TBNA specimens for EGFR testing in advanced, non-squamous, non-small cell lung cancer (NSCLC)...
2016: PloS One
Liliana Fernandez, Luz F Sua, Mauricio Velasquez, Aura Sanchez, Leidys Gutiérrez
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Oncology
Mehreen Fatima, Muhammad Aslam Khan, Shahid Jamal, Jawad Khaliq Ansari, Muhammad Usman Ullah
OBJECTIVE: To determine the sensitivity, specificity, negative and positive predictive values, and diagnostic accuracy of Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA). STUDY DESIGN: Across-sectional validation study. PLACE AND DURATION OF STUDY: Department of Histopathology, Army Medical College, in collaboration with Department of Pulmonology, Military Hospital Rawalpindi, from March 2014 to March 2015. METHODOLOGY: Cases of EBUS-TBNAcomprised of both TBNAs and cell block/biopsy of the same patients...
September 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Sahajal Dhooria, Inderpaul Singh Sehgal, Nalini Gupta, Babu Ram, Ashutosh Nath Aggarwal, Digambar Behera, Ritesh Agarwal
BACKGROUND: Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) requires a dedicated needle for aspiration of mediastinal lesions. There is no data on reuse of these needles. METHODS: This is a retrospective study of patients who underwent EBUS-TBNA with either new or reused EBUS-TBNA needles. The needles were reused after thorough cleaning with filtered water and organic cleaning solution, disinfection with 2.4% glutaraldehyde solution followed by ethylene oxide sterilization...
July 2016: Lung India: Official Organ of Indian Chest Society
Masanori Yasuo, Takashi Kobayashi, Mineyuki Hama, Takashi Ichiyama, Toshimichi Horiuchi, Hiroshi Yamamoto, Satoshi Kawakami, Kazutoshi Hamanaka, Takayuki Honda, Masayuki Hanaoka
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is frequently applied to the diagnosis of central airway lesions, and endobronchial ultrasound with a guide sheath (EBUS-GS) is mainly used for the diagnosis of peripheral pulmonary lesions. However, there remains an unmet need to improve the diagnostic yields for peribronchial pulmonary lesions located along the secondary/tertiary and fourth/fifth bronchi (the "middle third zone" of the lungs), which neither EBUS-TBNA nor EBUS-GS can easily approach...
September 2016: Respiratory Investigation
Asma Navasakulpong, Manon Auger, Anne V Gonzalez
BACKGROUND: Studies have reported a high diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of sarcoidosis. We sought to review the yield of EBUS-TBNA for the diagnosis of sarcoidosis at our institution over time, and examine factors that may influence this yield. METHODS: Patients who underwent EBUS-TBNA for suspected sarcoidosis between December 2008 and November 2011 were identified. EBUS was performed without rapid on-site evaluation (ROSE) of samples...
2016: BMJ Open Respiratory Research
Onur Fevzi Erer, Ceyda Anar, Serhat Erol, Serir Özkan
BACKGROUND/AIM: The aim of this study was to determine the diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal and hilar lymph nodes (LNs) in patients with known extrapulmonary malignancy. MATERIALS AND METHODS: Between March 2011 and August 2013, 378 EBUS-TBNA procedures were performed. Sixty-three (16.6%) of these were performed on known extrapulmonary malignancy patients. RESULTS: There were 28 male and 35 female patients, with median ages of 65 years (min-max: 53-87) and 57 years (min-max: 39-76), respectively...
2016: Turkish Journal of Medical Sciences
John Berger, Felix Zamora, Eitan Podgaetz, Rafael Andrade, H Erhan Dincer
BACKGROUND AND OBJECTIVES: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the procedure of choice for the evaluation of mediastinal/hilar lymph node enlargements. Granulomatous inflammation of the mediastinal/hilar lymph nodes is often identified on routine histology. In addition, mediastinal lymphadenopathy may be present with undiagnosed infection. We sought to determine the usefulness of routine cultures and histology for infectious etiologies in a fungal endemic area when granulomatous inflammation is identified...
July 2016: Endoscopic Ultrasound
Abdul Hamid Alraiyes, Pichapong Tunsupon, Fayez Kheir, Daniel A Salerno
OBJECTIVE: We presented a rare case of recurrent hepatocellular carcinoma after liver transplant manifested as an isolated mediastinal mass. METHODS: A 62-year-old man was referred for evaluation of atypical chest pain and abnormal finding of a computed tomography of the chest. He had history of chronic hepatitis C liver cirrhosis and hepatocellular carcinoma underwent orthotopic liver transplant as a curative treatment three years earlier. RESULTS: The computed tomography of the chest demonstrated paratracheal mediastinal lymphadenopathy...
2016: SAGE Open Med Case Rep
Felix D Zamora, Anas Moughrabieh, Heidi Gibson, Eitan Podgaetz, H Erhan Dincer
Endobronchial ultrasound-guided transbronchial needle aspiration has a low complication rate and is a cost-effective procedure for mediastinal staging and diagnosis when compared with the more invasive mediastinoscopy. There are increasing case reports of unexpected complications including equipment failures with and without significant medical consequences. Knowledge of complications, including those that are rare, is essential for the physician performing this minimally invasive procedure. We report a case of a retained foreign body from the unexpected separation of a distal spring/coil mechanism from the Olympus ViziShot Aspiration needle following early needle deployment within the working channel of the bronchoscope...
July 29, 2016: Journal of Bronchology & Interventional Pulmonology
Sory J Ruiz, Yaxia Zhang, Sanjay Mukhopadhyay
Despite mixed results in the literature, some clinicians continue to consider an elevated CD4/CD8 ratio in bronchoalveolar lavage (BAL) fluid to be supportive of a diagnosis of sarcoidosis. However, the CD4/CD8 ratio in mediastinal lymph nodes involved by sarcoidosis has not been extensively studied. The primary aim of this study was to evaluate the utility of the CD4/CD8 ratio in mediastinal lymph node aspirates obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for diagnosing sarcoidosis...
July 29, 2016: Journal of Bronchology & Interventional Pulmonology
Nikhil Meena, Wissam Abouzgheib, Setu Patolia, Justin Rosenheck, Ziad Boujaoude, Thaddeus Bartter
BACKGROUND: Clopidogrel is widely used for the prevention of thrombotic vascular complications. Its primary potential toxicity is bleeding. Management of clopidogrel therapy for patients undergoing invasive procedures is an area of ongoing study. We sought to evaluate the bleeding risk for patients undergoing needle aspiration biopsy by endobronchial ultrasound (EBUS) or esophageal ultrasound (EUS) while taking clopidogrel. METHODS: Retrospective review of sequential cases of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and esophageal ultrasound fine needle aspiration (EUS-FNA)...
July 29, 2016: Journal of Bronchology & Interventional Pulmonology
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