[Role of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal tuberculosis].

INTRODUCTION: Mediastinal tuberculosis (TB) is rare and a diagnostic challenge. Transbronchial needle aspiration guided by endoscopic ultrasonography (EBUS-TBNA) is an essential tool for staging and diagnosing patients with lung cancer but to date there are no studies in our environment evaluating its efficacy in mediastinal TB.

METHODS: Patients with a final diagnosis of isolated intrathoracic tuberculous lymphadenitis over a 6-year period were included. We analyzed the cases on whom EBUS-TBNA was performed.

RESULTS: Forty-six patients with mediastinal lymphadenopathy without pulmonary involvement were identified and 29 underwent EBUS-TBNA. In 28 of 29 patients (96.6%) EBUS-TBNA was diagnostic and cytological findings confirmed granulomas in 93% of cases. Microbiological investigation revealed positive TB culture in 14 (48.2%) and positive PCR for Mycobacterium tuberculosis in 30% of cases on whom it was carried out. Eighty-four per cent of the patients were immigrants and when compared with the native population we found statistical differences in immune status and culture yield.

CONCLUSION: EBUS-TBNA is a safe and effective technique in the diagnosis of patients with suspected mediastinal TB.