title: The diagnostic efficacy and safety of endobronchial ultrasound-guided transbronchial needle aspiration as an initial diagnostic tool.
abstract: OBJECTIVE
  Real-time, convex probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used for the staging of malignant mediastinal lymph nodes. We evaluated the diagnostic efficacy and safety of EBUS-TBNA when used as an initial diagnostic tool.
  
  
  METHODS
  We retrospectively studied 56 patients who underwent EBUS-TBNA as an initial diagnostic tool between August 2010 and December 2011. Procedure purpose were classified into four categories: 1) intrathoracic masses adjacent to the central airway; 2) enlarged lymph nodes for concurrent diagnosis and staging in suspected malignancy; 3) enlarged lymph nodes in suspected malignancy cases with inability to perform percutaneous core needle biopsy (PCNB); and 4) solely mediastinal masses/lymph nodes in lieu of mediastinoscopy.
  
  
  RESULTS
  The diagnostic accuracy of EBUS-TBNA regardless of procedure purpose was calculated to be 83.9%. Furthermore, the diagnostic accuracy of malignant disease was significantly higher than benign disease (93.9% vs. 70.6%, p < 0.001). The diagnostic accuracy of EBUS-TBNA for each disease is as follows: tuberculosis, 50%; sarcoidosis, 60%; aspergillosis, 100%; lung abscess, 100%; lung cancer, 93%; and lymphoma, 100%. There were minor complications in seven patients during the EBUS-TBNA procedure. The complications included mild hypoxia and bleeding.
  
  
  CONCLUSIONS
  In conclusion, EBUS-TBNA is a useful initial diagnostic tool for both benign and malignant diseases. EBUS-TBAN is also a very safe procedure and less invasive compared to mediastinoscopy or PCNB.
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Young Rak
authors.initials: YR
authors.lastname: Choi
authors.forename: Jin Young
authors.initials: JY
authors.lastname: An
authors.forename: Mi Kyeong
authors.initials: MK
authors.lastname: Kim
authors.forename: Hye-Suk
authors.initials: HS
authors.lastname: Han
authors.forename: Ki Hyeong
authors.initials: KH
authors.lastname: Lee
authors.forename: Si-Wook
authors.initials: SW
authors.lastname: Kim
authors.forename: Ki Man
authors.initials: KM
authors.lastname: Lee
authors.forename: Kang Hyeon
authors.initials: KH
authors.lastname: Choe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062005:Biopsy, Large-Core Needle; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Endobronchial ultrasound-guided transbronchial needle aspiration; Intrathoracic mass; Mediastinal mass