title: Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies.
abstract: OBJECTIVE
  Mediastinal lymphadenopathy is common in extrathoracic malignancies and should not always be considered a metastatic lesion. The purpose of this study is to determine the diagnostic value of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) in patients with extrathoracic malignancies.
  
  
  METHODS
  This study included 54 consecutive patients with extrathoracic malignancies who had suspected mediastinal metastases and had undergone EBUS-TBNA for diagnosis.
  
  
  RESULTS
  Using EBUS-TBNA, 27 of 54 patients (50%) were diagnosed with mediastinal metastases. Among patients with mediastinal metastases, 2 (3.7%) had a sarcoid-like reaction, 5 (9.3%) had tuberculosis, and 17 (31.5%) had reactive lymph nodes. In 3 cases (5.5%), a specific diagnosis could not be determined following EBUS-TBNA. Two patients underwent surgical staging of their mediastinal lymphadenopathy, which allowed the detection of mediastinal metastases in 1 patient and that of reactive lymph nodes in the other. The sensitivity, specificity, negative predictive value, and diagnostic accuracy of EBUS-TBNA for the diagnosis of extrathoracic malignancies were calculated as 93%, 100%, 92.6%, and 96.3%, respectively.
  
  
  CONCLUSIONS
  EBUS-TBNA is a safe and effective procedure. We should consider whether EBUS-TBNA should be the primary diagnostic tool for the diagnosis of mediastinal lymphadenopathy in patients with extrathoracic malignancies.
authors.affiliation: Department of Pulmonary Disease, Atatürk Training and Research Hospital, Ankara, Turkey. ayseguldr8@gmail.com
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Şentürk
authors.forename: Hatice
authors.initials: H
authors.lastname: Kiliç
authors.forename: Habibe
authors.initials: H
authors.lastname: Hezer
authors.forename: Funda
authors.initials: F
authors.lastname: Karaduman Yalçin
authors.forename: Hatice Canan
authors.initials: HC
authors.lastname: Hasanoğlu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology*; D012680:Sensitivity and Specificity; D055815:Young Adult