Open AccessRole of EBUS-TBNA in the diagnosis of tuberculosis and sarcoidosis
Author(s) -
Nalini Gupta,
Valliappan Muthu,
Ritesh Agarwal,
Sahajal Dhooria
Publication year - 2019
Publication title -
journal of cytology/journal of cytology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.267
H-Index - 19
eISSN - 0974-5165
pISSN - 0970-9371
DOI - 10.4103/joc.joc_150_18
Subject(s) - medicine , sarcoidosis , caseous necrosis , tuberculosis , mediastinal lymphadenopathy , endobronchial ultrasound , radiology , granulomatous inflammation , mediastinal diseases , pathology , cytology , dermatology , bronchoscopy , mediastinum , biopsy
Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) has diagnostic accuracy and negative predictive value for the diagnosis of mediastinal tubercular lymphadenitis, especially when culture and cytological diagnosis is combined with high clinical suspicion. Both sarcoidosis and tuberculosis (TB) demonstrate granulomatous inflammation on cytology. Diagnosis of sarcoidosis in regions with a high burden of TB is challenging. We conducted a prospective study in 179 cases of suspected granulomatous pathology in mediastinal lymphadenopathy cases to evaluate the role of EBUS-TBNA in diagnosis of sarcoidosis and TB. It was found that extensive caseous necrosis, acid-fast bacilli positivity on Ziehl-Neelsen staining, and/or microbiological culture positivity have high positive predictive value for the diagnosis of TB.