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Evaluation of endobronchial ultrasound‐guided fine‐needle aspirations (EBUS‐FNA): Correlation with adequacy and histologic follow‐up
Author(s) -
Karunamurthy Arivarasan,
Cai Guoping,
Dacic Sanja,
Khalbuss Walid E.,
Pantanowitz Liron,
Monaco Sara E.
Publication year - 2014
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.29
H-Index - 57
eISSN - 1934-6638
pISSN - 1934-662X
DOI - 10.1002/cncy.21350
Subject(s) - medicine , radiology , malignancy , lymph , endobronchial ultrasound , fine needle aspiration , biopsy , bronchoscopy , pathology
BACKGROUND Endobronchial ultrasound‐guided fine‐needle aspiration (EBUS‐FNA) is a minimally invasive modality for diagnosing mediastinal lesions. When determining adequacy, EBUS‐FNAs are evaluated for diagnostic material or sufficient lymphoid tissue. In this study, the authors evaluated their experience with EBUS‐FNAs and correlated the findings with adequacy and histologic follow‐up. METHODS EBUS‐FNAs were retrospectively reviewed over a 3‐year period and correlated with the clinicopathologic findings, adequacy, and histologic follow‐up. RESULTS In total, 593 EBUS‐FNAs were obtained from 356 patients, including 420 (71%) satisfactory (SAT) cases, 107 (18%) less than optimal (LTO) cases, and 66 (11%) unsatisfactory (UNSAT) cases. The overall diagnostic yield was 71%, and the mediastinal (N2) lymph nodes had better yield (72%) than the peripheral intrapulmonary and hilar (N1) lymph nodes (64%). Histologic follow‐up was available in 203 cases (34%), and malignancy was identified in 7 UNSAT cases (23%), 6 LTO‐negative cases (11%), and 4 SAT cases (3%) with a negative cytologic diagnosis. In the suboptimal cases with follow‐up, 79% were benign and 21% were malignant on follow‐up, including 25 (14%) with fibrosis or hyalinization. The sensitivity, specificity, and positive and negative predictive values in the study were 80%, 100%, 100%, and 95%, respectively. CONCLUSIONS The current data demonstrated that EBUS‐FNA has good sensitivity, high specificity, and a higher diagnostic yield for N2 lymph nodes compared with N1 lymph nodes. The data also illustrate the finding that suboptimal cases have a greater risk of false‐negative diagnoses and a 21% chance of malignancy, including processes with fibrosis or hyalinization. Cancer (Cancer Cytopathol) 2014;122:23–32 . © 2013 American Cancer Society .