title: Utility of endobronchial ultrasound-guided-fine-needle aspiration and additional value of cell block in the diagnosis of mediastinal granulomatous lymphadenopathy.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial fine-needle aspiration is a minimally invasive technique for diagnosis of mediastinal lesions. Although most studies have reported the utility of EBUS-FNA in malignancy, its use has been extended to the benign conditions as well.
  
  
  OBJECTIVE
  To evaluate the diagnostic yield and cytologic accuracy of endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-FNA) in cases of clinically and radiologically suspected granulomatous diseases.
  
  
  METHODS
  From May 2010 to April 2015, 43 of 115 patients who underwent EBUS-FNA at one center for radiologically and clinically suspicious granulomatous lesions, and with no definite histological diagnosis, were included in this retrospective study.
  
  
  RESULTS
  When the histological diagnosis was taken as the gold standard, the sensitivity of EBUS-FNA was 85% and specificity was 100% with the positive predictive value of 100. The combined diagnostic sensitivity of EBUS-FNA and transbronchial lung biopsy was 100%. In 4 cases, cell block provided an exclusive morphological diagnosis of sarcoidosis which was noncontributory by EBUS-FNA.
  
  
  CONCLUSIONS
  Our study supports the use of EBUS-FNA, by virtue of being a safe, minimally invasive, and an outpatient procedure, in the diagnosis of granulomatous mediastinal lymphadenopathy, thereby obviating more invasive testing in a significant number of patients. Also, cell block provides additional data in the diagnosis in these benign mediastinal diseases.
authors.affiliation: Address: , Department of Histopathology, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia.
authors.forename: Shaesta Naseem
authors.initials: SN
authors.lastname: Zaidi
authors.affiliation: Address: , Department of Histopathology, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia ; Department of Histopathology, Al-Faisal University, Riyadh, Saudi Arabia.
authors.forename: Emad
authors.initials: E
authors.lastname: Raddaoui
keywords: Cell block; endoscopic ultrasound guided transbronchial fine-needle aspiration; granulomatous diseases