Endobronchial ultrasound-guided transbronchial needle aspiration is useful in the diagnosis of lymphoma: don't give up!

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is considered cautiously in the diagnosis of lymphoma. In this study, we present our data with literature review, to ask the readers to re-evaluate this opinion.

MATERIALS AND METHODS: Several demographic, clinical and procedural variables of patients who had been diagnosed with lymphoma with EBUS-TBNA at our institution between January 2011 and December 2016 were noted and analyzed.

RESULTS: We analyzed 27 patients with a proven diagnosis of lymphoma, out of whom twenty patients were with classical Hodgkin's lymphoma and seven with non-Hodgkin's lymphoma. The sensitivity, specificity, positive and negative predictive values and accuracy of EBUS-TBNA for the diagnosis of lymphoma was found to be 70.3 %, 100 %, 100 %, 99.4 % and 99.4 %, respectively. The diagnostic sensitivity of EBUS-TBNA in ten patients with the history of lymphoma was 100 %; while in patients with no history of lymphoma it was 52.9 %. The patients with non-Hodgkin's lymphoma were presented at older ages (p = 0.001), with larger lesions (p = 0.046) and higher SUVmax values (p < 0.001). No complications occurred.

CONCLUSION: EBUS-TBNA may be used as an initial diagnostic modality in patients suspicious for lymphoma instead of repeated mediastinoscopy (Tab. 2, Fig. 1, Ref. 34).