Abstract
Background/Purpose: Isolated intrathoracic lymphadenopathy (IT-LAP) is clinically challenging because of the difficult anatomic location and wide range of associated diseases, including tuberculosis (TB). Although sampling via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histopathology is a major development, there is still room for improvement. This study aimed to investigate an algorithmic approach driven by EBUS-TBNA and conventional bronchoscopy to streamline the management of IT-LAP. Methods: Eighty-three prospectively enrolled patients with IT-LAP were subjected to an EBUS-TBNA diagnostic panel test (histopathology, cytology, and microbiology) and underwent conventional bronchoscopy for bronchoalveolar lavage. The results were structured into an algorithmic approach to direct patient treatment, workup, or follow-up. Results: The diagnostic yields of EBUS-TBNA based on histopathology were similar for each disease entity: 77.8% for malignancy, 70.0% for TB, 75.0% for sarcoidosis, 80.0% for anthracosis, and 70.0% for lymphoid hyperplasia (p=0.96). The incidence of malignancy was 10.8% for total IT-LAP patients, and 12.0% and 33.7% for patients with TB and sarcoidosis, respectively. Thirty-five (42.2%) patients were symptomatic. The leading diagnosis was sarcoidosis (60%), followed by TB (20%), malignancy (11.4%), lymphoid hyperplasia (5.7%), and anthracosis (2.9%). By logistic regression analysis, granulomatous disease (odds ratio: 13.45; 95% confidence interval: 4.45-40.67, p
| Original language | English |
|---|---|
| Pages (from-to) | 527-534 |
| Number of pages | 8 |
| Journal | Journal of the Formosan Medical Association = Taiwan yi zhi |
| Volume | 113 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 2014 |
| Externally published | Yes |
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Keywords
- EBUS-TBNA
- Intrathoracic lymphadenopathy
- Malignancy
- Tuberculosis
ASJC Scopus subject areas
- Medicine(all)
Cite this
Algorithmic approach by endobronchial ultrasound-guided transbronchial needle aspiration for isolated intrathoracic lymphadenopathy : A study in a tuberculosis-endemic country. / Kuo, Chih Hsi; Lin, Shu Min; Lee, Kang Yun; Chung, Fu Tsai; Feng, Po Hao; Hsiung, Te Chih; Lo, Yu Lun; Liu, Chien Ying; Kuo, Han Pin.
In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 113, No. 8, 2014, p. 527-534.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Algorithmic approach by endobronchial ultrasound-guided transbronchial needle aspiration for isolated intrathoracic lymphadenopathy
T2 - A study in a tuberculosis-endemic country
AU - Kuo, Chih Hsi
AU - Lin, Shu Min
AU - Lee, Kang Yun
AU - Chung, Fu Tsai
AU - Feng, Po Hao
AU - Hsiung, Te Chih
AU - Lo, Yu Lun
AU - Liu, Chien Ying
AU - Kuo, Han Pin
PY - 2014
Y1 - 2014
N2 - Background/Purpose: Isolated intrathoracic lymphadenopathy (IT-LAP) is clinically challenging because of the difficult anatomic location and wide range of associated diseases, including tuberculosis (TB). Although sampling via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histopathology is a major development, there is still room for improvement. This study aimed to investigate an algorithmic approach driven by EBUS-TBNA and conventional bronchoscopy to streamline the management of IT-LAP. Methods: Eighty-three prospectively enrolled patients with IT-LAP were subjected to an EBUS-TBNA diagnostic panel test (histopathology, cytology, and microbiology) and underwent conventional bronchoscopy for bronchoalveolar lavage. The results were structured into an algorithmic approach to direct patient treatment, workup, or follow-up. Results: The diagnostic yields of EBUS-TBNA based on histopathology were similar for each disease entity: 77.8% for malignancy, 70.0% for TB, 75.0% for sarcoidosis, 80.0% for anthracosis, and 70.0% for lymphoid hyperplasia (p=0.96). The incidence of malignancy was 10.8% for total IT-LAP patients, and 12.0% and 33.7% for patients with TB and sarcoidosis, respectively. Thirty-five (42.2%) patients were symptomatic. The leading diagnosis was sarcoidosis (60%), followed by TB (20%), malignancy (11.4%), lymphoid hyperplasia (5.7%), and anthracosis (2.9%). By logistic regression analysis, granulomatous disease (odds ratio: 13.45; 95% confidence interval: 4.45-40.67, p
AB - Background/Purpose: Isolated intrathoracic lymphadenopathy (IT-LAP) is clinically challenging because of the difficult anatomic location and wide range of associated diseases, including tuberculosis (TB). Although sampling via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histopathology is a major development, there is still room for improvement. This study aimed to investigate an algorithmic approach driven by EBUS-TBNA and conventional bronchoscopy to streamline the management of IT-LAP. Methods: Eighty-three prospectively enrolled patients with IT-LAP were subjected to an EBUS-TBNA diagnostic panel test (histopathology, cytology, and microbiology) and underwent conventional bronchoscopy for bronchoalveolar lavage. The results were structured into an algorithmic approach to direct patient treatment, workup, or follow-up. Results: The diagnostic yields of EBUS-TBNA based on histopathology were similar for each disease entity: 77.8% for malignancy, 70.0% for TB, 75.0% for sarcoidosis, 80.0% for anthracosis, and 70.0% for lymphoid hyperplasia (p=0.96). The incidence of malignancy was 10.8% for total IT-LAP patients, and 12.0% and 33.7% for patients with TB and sarcoidosis, respectively. Thirty-five (42.2%) patients were symptomatic. The leading diagnosis was sarcoidosis (60%), followed by TB (20%), malignancy (11.4%), lymphoid hyperplasia (5.7%), and anthracosis (2.9%). By logistic regression analysis, granulomatous disease (odds ratio: 13.45; 95% confidence interval: 4.45-40.67, p
KW - EBUS-TBNA
KW - Intrathoracic lymphadenopathy
KW - Malignancy
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=84904385518&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904385518&partnerID=8YFLogxK
U2 - 10.1016/j.jfma.2013.06.012
DO - 10.1016/j.jfma.2013.06.012
M3 - Article
C2 - 23856346
AN - SCOPUS:84904385518
VL - 113
SP - 527
EP - 534
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
SN - 0929-6646
IS - 8
ER -