title: Endosonography for the diagnosis of malignant lymphoma presenting with mediastinal lymphadenopathy.
abstract: BACKGROUND
  Endosonography combined with fine needle aspiration (FNA) is a minimally invasive technique for intrathoracic mediastinal nodal sampling. The value of endosonography with FNA for the diagnosis of malignant mediastinal lymphoma is under debate. In this study, the sensitivity and negative predictive value of endosonography for the assessment of primary versus recurrent malignant lymphoma were assessed.
  
  
  METHODS
  Forty-nine patients with suspected primary (n=32) or recurrent (n=17) lymphoma were retrospectively analyzed. They presented with mediastinal nodal enlargement and underwent endosonography for diagnostic purposes between 2001 and 2011. The final diagnosis was based on surgical biopsy, conclusive cell block analysis, or longstanding clinical and radiologic follow-up.
  
  
  RESULTS
  In 33 patients, a final diagnosis of lymphoma was established; in 16 patients (33%) alternative diagnoses (eg, small cell lung cancer, sarcoidosis) were found. Sensitivity and negative predictive value of endosonography in diagnosing primary versus recurrent mediastinal lymphoma were 55% and 57% versus 88% and 90%, respectively. No complications occurred during these procedures.
  
  
  CONCLUSIONS
  On the basis of these data, we conclude that endosonography is a minimally invasive, safe, and sensitive method for the assessment of recurrent mediastinal malignant lymphoma or alternative diagnoses but has limitations in assessing a primary lymphoma diagnosis.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Talebian Yazdi
authors.affiliation: Departments of *Pulmonology §Hematology ‡Pathology, Leiden University Medical Center (LUMC) †Department of Pulmonology, Medical Center Leeuwarden (MCL) ∥Department of Pulmonology, Academic Medical Center Amsterdam (AMC), Amsterdam, The Netherlands.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Talebian-Yazdi
authors.forename: Martin B
authors.initials: MB
authors.lastname: von Bartheld
authors.forename: Bob
authors.initials: B
authors.lastname: von Bartheld
authors.forename: Femke G M
authors.initials: FG
authors.lastname: Waaijenborg
authors.forename: Femke
authors.initials: F
authors.lastname: Waaijenborg
authors.forename: Johannes
authors.initials: J
authors.lastname: Nabers
authors.forename: Hans
authors.initials: H
authors.lastname: Nabes
authors.forename: Ben J W
authors.initials: BJ
authors.lastname: Venmans
authors.forename: Ben
authors.initials: B
authors.lastname: Venmans
authors.forename: Maud
authors.initials: M
authors.lastname: Veselic-Charvat
authors.forename: Patty M
authors.initials: PM
authors.lastname: Jansen
authors.forename: Patty
authors.initials: P
authors.lastname: Jansen
authors.forename: Erik W
authors.initials: EW
authors.lastname: Marijt
authors.forename: Erik
authors.initials: E
authors.lastname: Marijt
authors.forename: Jouke T
authors.initials: JT
authors.lastname: Annema
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity