title: Diagnostic value of blood clot core during endobronchial ultrasound-guided transbronchial needle aspirate.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is being increasingly used in the sampling of pulmonary masses and mediastinal lymphadenopathy. The blood clot core (BCC) often obtained during EBUS-TBNA may not be a true core and therefore may not be submitted for histological analysis. The frequency in which the blood clot core is positive in patients with negative cytology undergoing EBUS-TBNA is not known. The purpose of this study was to evaluate the diagnostic role of the blood clot core obtained during EBUS-TBNA.
  
  
  METHODS
  An Institutional Review Board-approved retrospective chart review was performed from January through September 2011 for all patients who underwent EBUS-TBNA at The Ohio State University. The data collection included cytology and histology results for each procedure. Blood clot cores obtained from the EBUS-TBNA needle were sent in formalin for histological examination.
  
  
  RESULTS
  Seventy patients underwent EBUS-TBNA and 51 (72.8 %) patients had procedures that yielded a BCC for histology and aspirate for cytology. Forty-nine percent of patients with a BCC were diagnosed with malignancy. Of those with a BCC obtained, five (9.8 %) patients diagnosed with malignancy were done so based only on the results of blood clot core alone with negative cytology.
  
  
  CONCLUSIONS
  Blood clot cores obtained at EBUS-TBNA contain diagnostic material and should be subjected histopathological examination. When blood clot cores are sent for analysis, there is the potential to spare up to 10 % of patients more invasive diagnostic biopsy procedures.
authors.affiliation: Division of Allergy, Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Medical Center, 201 DHLRI, 473 West 12th Avenue, Columbus, OH, 43210, USA. emily.amin@osumc.edu
authors.forename: Emily N
authors.initials: EN
authors.lastname: Amin
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Russell
authors.forename: Konstantin
authors.initials: K
authors.lastname: Shilo
authors.forename: Shaheen
authors.initials: S
authors.lastname: Islam
authors.forename: Karen L
authors.initials: KL
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D001999:Bronchoscopy; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009820:Ohio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055815:Young Adult
references.citation: Chest. 2007 Sep;132(3 Suppl):202S-220S
references.pmid: 17873169
references.citation: Chest. 2004 Jan;125(1):322-5
references.pmid: 14718460
references.citation: Cancer Cytopathol. 2012 Jun 25;120(3):185-95
references.pmid: 22144401
references.citation: J Korean Med Sci. 2011 Feb;26(2):274-8
references.pmid: 21286021
references.citation: Chest. 2005 Aug;128(2):869-75
references.pmid: 16100180
references.citation: Chest. 2008 Aug;134(2):368-374
references.pmid: 18263688
references.citation: J Thorac Cardiovasc Surg. 2010 Jun;139(6):1554-60
references.pmid: 20494195
references.citation: Ann Thorac Surg. 2011 Mar;91(3):831-6
references.pmid: 21353007
references.citation: Respirology. 2007 Nov;12(6):863-8
references.pmid: 17986115
references.citation: J Thorac Oncol. 2008 Jun;3(6):577-82
references.pmid: 18520794
references.citation: JAMA. 2008 Feb 6;299(5):540-6
references.pmid: 18252884
references.citation: J Thorac Cardiovasc Surg. 2011 Dec;142(6):1393-400.e1
references.pmid: 21963329