title: Combination of endobronchial ultrasound-guided transbronchial needle aspiration with standard bronchoscopic techniques enhanced the diagnosis yields of pulmonary tuberculosis patients with lymphadenopathy.
abstract: OBJECTIVE
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was reported to be useful for diagnosis of tuberculosis (TB) lymphadenitis, although its indication remains unclear for suspicious pulmonary TB patients. To clarify the role of EBUS-TBNA for the diagnosis of immunocompetent TB patients with intrathoracic lymphadenopathy, we compared two diagnostic modalities: traditional bronchoscopy alone and EBUS-TBNA combined with bronchoscopy.
  
  
  METHODS
  We retrospectively studied 175 patients of suspicious pulmonary TB with intrathoracic lymphadenopathy in a single institute (Tongji University, Shanghai, China) from January 2010 to May 2011.
  
  
  RESULTS
  Ninety-seven patients underwent traditional bronchoscopy alone while 78 received the combined diagnostic techniques. Sensitivity and specificity were 18.1% and 100%, respectively, in the bronchoscopy group alone, and 80% and 92.3%, respectively, in the EBUS-TBNA combination group (absolute increase in sensitivity, 61.9%; P<0.001; 95% CI, 48.7-75.1%). In the combination group, EBUS-TBNA alone was diagnostic of TB in 42 patients (64.6%, 95% CI, 53-76.2%). Bleeding without hemodynamic instability developed in two patients during the procedure of EBUS-TBNA and no hospitalization prolongation happened in the both arms.
  
  
  CONCLUSIONS
  Combination of EBUS-TBNA with standard bronchoscopic technique is safe and significantly increases the diagnostic yield in patients of suspicious pulmonary TB with lymphadenopathy.
authors.affiliation: Department of Medical Oncology Shanghai Pulmonary Hospital Tongji University School of Medicine, Shanghai, China - wanghao21384313@126.com.
authors.forename: S
authors.initials: S
authors.lastname: Ren
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.forename: H
authors.initials: H
authors.lastname: Jiang
authors.forename: C
authors.initials: C
authors.lastname: Wu
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.forename: L
authors.initials: L
authors.lastname: Liang
authors.forename: B
authors.initials: B
authors.lastname: Li
authors.forename: L
authors.initials: L
authors.lastname: Liu
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: G
authors.initials: G
authors.lastname: Schmid-Bindert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000009:adverse effects; D002681:China; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D055815:Young Adult