Endobronchial ultrasound-guided transbronchial fine-needle aspiration

被引:119
作者
Alsharif, Mariam [1 ]
Andrade, Rafael S. [2 ]
Groth, Shawn S. [2 ]
Stelow, Edward B. [3 ]
Pambuccian, Stefan E. [1 ]
机构
[1] Univ Minnesota, Dept Lab Med & Pathol, Minneapolis, MN 55455 USA
[2] Univ Minnesota, Dept Surg, Minneapolis, MN 55455 USA
[3] Univ Virginia, Dept Pathol, Charlottesville, VA 22903 USA
关键词
pulmonary and mediastinal cytology; fine-needle aspiration; endobronchial ultrasound; adequacy;
D O I
10.1309/BLLQF8KDHWW6MJNQ
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) is a new technique that facilitates cytologic sampling of mediastinal lymph nodes. We describe our initial experience with this method, including adequacy assessment, impact on cytopathologists' work, and diagnostic pitfalls. There were 229 EBUS-TBNA samples obtained from 100 patients; a mean of 22 minutes was spent with an average of 3 passes performed and 6 slides prepared per site. Of 193 aspirates, 5 were categorized as atypical, 54 as positive, and 134 as negative for malignancy; 36 (15.7%) aspirated were nondiagnostic. We found EBUS-TBNA to have a high specificity (100%) and good sensitivity (86%) in our institution, in which a cytopathologist is available on-site to ensure sample adequacy. Most true-negative samples had moderate to abundant lymphocytes, confirming lymphocyte numbers as a marker of adequacy. For pathologists, this was a relatively time-consuming procedure. Recognizing bronchial contamination, especially with metaplastic or dysplastic cells, is important for avoiding diagnostic pitfalls.
引用
收藏
页码:434 / 443
页数:10
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