The contribution of cell blocks in the diagnosis of mediastinal masses and hilar adenopathy samples from echobronchoscopy.
BACKGROUND
Cell block material from puncture can be obtained with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in many cases. The aim of this study was to analyse the value of additional information from cell blocks obtained with EBUS-TBNA samples from mediastinal and hilar lymph nodes and masses.


METHODS
Review of pathology reports with a specific diagnosis obtained from EBUS-TBNA samples of mediastinal or hilar lesions, prospectively obtained over a two-year period. The generation of cell blocks from cytology needle samples, the contribution to morphological diagnosis, and the possible use of samples for immunohistochemistry were analysed.


RESULTS
One hundred and twenty-nine samples corresponding to 110 patients were reviewed. The diagnosis was lung cancer in 81% of cases, extrapulmonary carcinoma in 10%, sarcoidosis in 4%, lymphoma in 2.7%, and tuberculosis in 0.9%. Cell blocks could be obtained in 72% of cases. Immunohistochemistry studies on the cell blocks were significantly easier to perform than on conventional smears (52.6% vs. 14%, P<.0001). In 4cases, the cell block provided an exclusive morphological diagnosis (3sarcoidosis and one metastasis from prostatic carcinoma) and in 3carcinomas, subtype and origin could be identified. Exclusive diagnoses from the cell block were significantly more frequent in benign disease than in malignant disease (25% vs 0.9%, P=.002).


CONCLUSIONS
Cell blocks were obtained from 72% of EBUS-TBNA diagnostic procedures. The main contributions of cell blocks to pathology examinations were the possibility of carrying out immunohistochemical staining for the better classification of neoplasms, especially extrapulmonary metastatic tumours, and the improved diagnosis of benign lesions.
Servicio de Neumología, Instituto de Investigación Biomédica de Vigo, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Pontevedra, España.
Tamara
T
Lourido-Cebreiro
Servicio de Neumología, Instituto de Investigación Biomédica de Vigo, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Pontevedra, España.
Virginia
V
Leiro-Fernández
Servicio de Anatomía Patológica, Instituto de Investigación Biomédica de Vigo, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Pontevedra, España.
Antoni
A
Tardio-Baiges
Servicio de Neumología, Instituto de Investigación Biomédica de Vigo, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Pontevedra, España.
Maribel
M
Botana-Rial
Servicio de Neumología, Instituto de Investigación Biomédica de Vigo, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Pontevedra, España.
Manuel
M
Núñez-Delgado
Servicio de Anatomía Patológica, Instituto de Investigación Biomédica de Vigo, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Pontevedra, España.
M Jesús
MJ
Álvarez-Martín
Servicio de Neumología, Instituto de Investigación Biomédica de Vigo, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Pontevedra, España. Electronic address: alberto.fernandez.villar@sergas.es.
Alberto
A
Fernández-Villar
D001999:Bronchoscopy; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008482:Mediastinum; D008875:Middle Aged; D012189:Retrospective Studies
Adenopatías mediastínicas e hiliares; Bloque celular; Cell block; Ecografía endobronquial; Endobronchial ultrasound; Enfermedad neoplásica; Mediastinal and hilar adenopathies; Neoplastic disease; Punción aspiración transbronquial; Transbronchial aspiration