Original articleGeneral thoracicEndobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Diagnosing Intrathoracic Tuberculosis
Section snippets
Patients and Methods
The role of EBUS-TBNA in diagnosing TB was prospectively studied at a clinical center for thoracic medicine. Patient enrollment was performed from January 2010 to December 2011. Follow-up was conducted through December 2012. Endobronchial ultrasound-guided transbronchial needle aspiration was performed according to the following guidelines: (1) enlarged mediastinal/hilar lymph nodes (≥1 enlarged mediastinal or hilar lymphadenopathy >1 cm in short-axis) and/or tracheobronchial wall-adjacent
Results
Of 59 eligible patients, 27 were male, and the median age was 49 years (range, 17 to 70 years). TB was confirmed in 41 patients, lung cancer in 5, inflammation in 7, and sarcoidosis in 6. A TB diagnosis was established by EBUS-TBNA exclusively in 25 patients, by WLB exclusively in 2, by both EBUS-TBNA and WLB in 10, by thoracotomy in 3 (1 had confirmed-negative lymph nodes, suggesting that the EBUS-TBNA results were true-negatives, the other 2 being false-negatives), and by CT-TTNA in one (Fig 1
Comment
Pathology and bacteriology evidence of TB infection is considered the standard for diagnosis in those suspected of having intrathoracic TB. Surgical approaches, ie, mediastinoscopy and thoracoscopy, have the highest success rates but are more invasive, expensive, and need inpatient general anaesthesia. Furthermore, there is a 0.05% mortality with mediastinoscopy, and posterior-lower carinal and hilar nodes stations are generally inaccessible 12, 13. Less invasive measures are thus used:
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