title: The role of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal and hilar lymph node metastases in patients with extrapulmonary malignancy.
abstract: OBJECTIVE
  The determination of mediastinal lymphadenopathy is important in the management of extrapulmonary malignancy. The purpose of this study was to determine the diagnostic performance of EBUS-TBNA in the diagnosis of mediastinal and hilar lymphadenopathy in patients with proven or suspicious extrapulmonary malignancy.
  
  
  METHODS
  Retrospective analysis was performed in 57 patients (81 lesions) with proven (n=51) or suspicious (n=6) extrapulmonary malignancies who underwent EBUS-TBNA between May 2009 and January 2011.
  
  
  RESULTS
  There were 37 male and 20 female patients, with a median age of 64 years. Thirty-five (61.4%) patients were confirmed as malignancy (34 extrapulmonary malignancy and 1 primary lung cancer) and 22 (38.6%) patients were confirmed as benign. EBUS-TBNA identified malignancy in 30 patients. One patient who was diagnosed as primary lung cancer was excluded from diagnostic performance analysis. Overall cancer prevalence was 61% in 56 study patients. The diagnostic sensitivity, accuracy, and negative predictive value of EBUS-TBNA per patient were 88%, 93%, and 85%. The diagnostic sensitivity, accuracy, and negative predictive value of PET/CT scan per patient were 81%, 82%, and 71%, respectively. There were no serious complications related to EBUS-TBNA.
  
  
  CONCLUSIONS
  Since mediastinal and hilar lymphadenopathy do not always result from metastases in patients with extrapulmonary malignancy, histopathologic confirmation is mandatory. EBUS-TBNA is a sensitive modality and can be considered as the initial test for the histopathological diagnosis of mediastinal and hilar lymphadenopathy in patients with extrapulmonary malignancy.
authors: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea.
authors: Jae-Uk
authors: JU
authors: Song
authors: Hye Yun
authors: HY
authors: Park
authors: Kyeongman
authors: K
authors: Jeon
authors: Won-Jung
authors: WJ
authors: Koh
authors: Gee Young
authors: GY
authors: Suh
authors: Man Pyo
authors: MP
authors: Chung
authors: Hojoong
authors: H
authors: Kim
authors: O Jung
authors: OJ
authors: Kwon
authors: Sang-Won
authors: SW
authors: Um
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods