title: Rapid diagnosis of mediastinal tuberculosis with polymerase chain reaction evaluation of aspirated material taken by endobronchial ultrasound-guided transbronchial needle aspiration.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a diagnostic method for tuberculosis (TB). This study was conducted to determine the efficiency of polymerase chain reaction (PCR) testing for detecting TB lymphadenitis in samples obtained by EBUS-TBNA.
  
  
  METHODS
  A total of 93 consecutive patients with hilar/mediastinal lymphadenopathies and diagnosed with granulomatous diseases through histopathological evaluation were included in the study. The specimens provided by EBUS-TBNA were evaluated through pathological, microbiological, and molecular tests.
  
  
  RESULTS
  Eighty-nine (95.7%) of the 93 patients had histopathologically granulomatous diseases by EBUS-TBNA. Tuberculosis was diagnosed in 27 (30.3%) patients and sarcoidosis was diagnosed in 62 (69.7%) patients. Four (4.3%) patients were diagnosed through mediastinoscopy. Endobronchial ultrasound-guided transbronchial needle aspiration had an overall diagnostic efficiency in TB of 96.9%, a sensitivity of 90.9%, and a specificity of 100%. Mycobacterium tuberculosis PCR was positive in 17 of the 30 patients. The sensitivity of PCR was 56.7%, the specificity was 100%, and the general efficiency of the test was 96.4%.
  
  
  CONCLUSIONS
  As a result, the use of M. tuberculosis PCR in the EBUS-TBNA specimens provides a rapid and an accurate diagnosis of TB. Therefore, we recommend the use of M. tuberculosis PCR in the EBUS-TBNA specimens as a rapid diagnostic method for mediastinal lymphadenopathies in patients with suspected TB.
authors.affiliation: From the *Department of Pulmonary Diseases, Ankara Ataturk Training and Research Hospital; and †Department of Pulmonary Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Senturk
authors.forename: Emine
authors.initials: E
authors.lastname: Arguder
authors.forename: Habibe
authors.initials: H
authors.lastname: Hezer
authors.forename: Elif
authors.initials: E
authors.lastname: Babaoglu
authors.forename: Hatice
authors.initials: H
authors.lastname: Kilic
authors.forename: Aysegul
authors.initials: A
authors.lastname: Karalezli
authors.forename: H Canan
authors.initials: HC
authors.lastname: Hasanoglu
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging* / Q000235:genetics*; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D013997:Time Factors; D014376:Tuberculosis / Q000000981:diagnostic imaging* / Q000235:genetics*; D018084:Ultrasonography, Interventional / Q000379:methods*; D055815:Young Adult