title: Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis and staging of mediastinal lymphadenopathy: initial experience in Brazil.
abstract: OBJECTIVE
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of mediastinal lymph nodes. The objective of this study was to evaluate the preliminary results obtained with EBUS-TBNA in the diagnosis of lesions and mediastinal lymph node staging.
  
  
  METHODS
  We evaluated patients with tumors or mediastinal adenopathy, diagnosed with or suspected of having lung cancer. The procedures were performed with the patients under sedation or under general anesthesia. Material was collected by EBUS-TBNA, after which it was prepared on slides, fixed in either absolute alcohol (for cytology) or formalin (for cell-block analysis).
  
  
  RESULTS
  We included 50 patients (30 males). The mean age was 58.3 ± 13.5 years. We performed 201 biopsies of 81 lymph nodes or mediastinal masses (mean of 2.5 punctures/biopsy). The quantity of material was considered sufficient for cytology in 37 patients (74%), 21 (57%) of whom were thus diagnosed with malignancy. Of the remaining 16 patients, 1 was diagnosed with tuberculosis, 6 entered clinical follow-up, and 9 underwent further investigation (2 diagnosed with neoplasm-false-negative results). The yield was higher when the procedure was performed for diagnostic purposes, as well as being higher in patients with lesions in multiple stations and in biopsies involving the subcarinal lymph node station. One patient had endobronchial bleeding, which was resolved with local measures. There were no deaths among the patients evaluated.
  
  
  CONCLUSIONS
  This preliminary experience shows that EBUS-TBNA is a safe procedure. Our diagnostic yield, although lower than that reported in the literature, was consistent with the learning curve for the method.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. tedde@usp.br
authors.forename: Miguel Lia
authors.initials: ML
authors.lastname: Tedde
authors.forename: Viviane Rossi
authors.initials: VR
authors.lastname: Figueiredo
authors.forename: Ricardo Mingarini
authors.initials: RM
authors.lastname: Terra
authors.forename: Hélio
authors.initials: H
authors.lastname: Minamoto
authors.forename: Fábio Biscegli
authors.initials: FB
authors.lastname: Jatene
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods / Q000592:standards; D001938:Brazil; D001999:Bronchoscopy / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods