title: Value of real-time endobronchial ultrasound-guided transbronchial needle aspiration.
abstract: OBJECTIVE
  The diagnostic value of real-time convex-probe endobronchial ultrasound (CP-EBUS)-guided transbronchial needle aspiration (TBNA) in mediastinal pathologies, and the factors influencing it are not clearly known. This study has been designed to examine factors affecting the efficacy and diagnostic value of CP-EBUS-TBNA.
  
  
  METHODS
  Patients (n = 321) with mediastinal mass or enlarged lymph node in the mediastinum, participated in this study, conducted between April 2007 and May 2009. Samples were obtained from the lesions using the TBNA method, with the guidance of CP-EBUS. Histopathologic (in all samples) and microbiologic (in 151 patients' samples) evaluations were carried out. Biopsy using an appropriate surgical method was taken when the result of the TBNA procedure was nondiagnostic. Thirty-four patients were excluded from the analysis due to several reasons. The diagnostic efficacy of the procedure was analyzed in the remaining 287 patients.
  
  
  RESULTS
  The diagnostic rate was 92% (89.7% for the benign diseases and 92.6% for the malignant diseases (P = 0.59)). In granulomatous diseases, the rate was 96% for sarcoidosis and 79% for tuberculosis (P = 0.002). Patients in whom only one lymph node was sampled and in whom two or more lymph nodes were sampled had a diagnostic rate of 85% and 95%, respectively (P = 0.03). When left hilar nodes were sampled, a higher diagnostic rate was achieved (P = 0.01).
  
  
  CONCLUSIONS
  CP-EBUS-guided TBNA has a high diagnostic rate. Sampling of at least two separate lymph nodes and the discovery of left hilar station in these lymph nodes increase the rate of diagnosis.
authors.affiliation: Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey.
authors.forename: Erdogan
authors.initials: E
authors.lastname: Cetinkaya
authors.forename: Gulsah
authors.initials: G
authors.lastname: Gunluoglu
authors.forename: Akif
authors.initials: A
authors.lastname: Ozgul
authors.forename: Mehmet Z
authors.initials: MZ
authors.lastname: Gunluoglu
authors.forename: Guler
authors.initials: G
authors.lastname: Ozgul
authors.forename: Ekrem C
authors.initials: EC
authors.lastname: Seyhan
authors.forename: Atayla
authors.initials: A
authors.lastname: Gencoglu
authors.forename: Sule
authors.initials: S
authors.lastname: Gul