title: Endobronchial ultrasound transbronchial needle aspiration in mediastinal and hilar lymphadenopathies.
abstract: OBJECTIVE
  Endobronchial ultrasound (EBUS)-transbronchial needle aspiration (TBNA) is a relatively noninvasive technique that allows sampling of mediastinal and hilar lymph nodes or masses under real-time and direct visualization, overcoming some of the problems associated with mediastinoscopy and blind TBNA. The goal of this study was to evaluate the yield of this technique in patients with and without malignant disease in a newly started EBUS program involving physicians not previously fully trained in interventional pulmonology.
  
  
  METHODS
  Between March 2010 and July 2011, 43 patients with enlarged lymph nodes (>1 cm on short axis) on chest computed tomography who underwent EBUS-TBNA were included in the study. Nondiagnostic results were confirmed with mediastinoscopy. The sensitivity, specificity, positive predictive value and negative predictive value of the technique were assessed.
  
  
  RESULTS
  Among the 43 patients who underwent EBUS-TBNA, a correct diagnosis was made in 39 of the 43 patients (91%). The sensitivity, specificity, positive predictive value, and negative predictive values were 89%, 100%, 100%, and 67%, respectively. The success rate, complication rate, and 30-day mortality were 91%, 0%, and 0%, respectively.
  
  
  CONCLUSIONS
  EBUS-TBNA is a safe and effective approach with high diagnostic yield and minimal complications for diagnosing and staging of mediastinal/hilar lymph nodes. Satisfactory results can be obtained immediately by pulmonologists experienced in conventional bronchoscopy with the provision of additional training on the technique.
authors.affiliation: Section of Pulmonary, Critical Care, and Environmental Medicine at Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, USA. fkheir@tulane.edu
authors.forename: Fayez
authors.initials: F
authors.lastname: Kheir
authors.forename: Jaime
authors.initials: J
authors.lastname: Palomino
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional