title: Efficacy of TB-PCR using EBUS-TBNA samples in patients with intrathoracic granulomatous lymphadenopathy.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is widely used to perform mediastinal lymph node sampling. However, little information is available on polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) using EBUS-TBNA samples in patients with intrathoracic granulomatous lymphadenopathy (IGL).
  
  
  METHODS
  A retrospective study using a prospectively collected database was performed from January 2010 to December 2014 to evaluate the efficacy of the TB-PCR test using EBUS-TBNA samples in patients with IGL. During the study period, 87 consecutive patients with isolated intrathoracic lymphadenopathy who received EBUS-TBNA were registered and 46 patients with IGL were included.
  
  
  RESULTS
  Of the 46 patients with IGL, tuberculous lymphadenitis and sarcoidosis were diagnosed in 16 and 30 patients, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of TB-PCR for tuberculous lymphadenitis were 56, 100, 100, and 81%, respectively. The overall diagnostic accuracy of TB-PCR for tuberculous lymphadenitis was 85%. In addition, seven (17%) patients had non-diagnostic results from a histological examination and all of them had non-diagnostic microbiological results of an acid-fast bacilli smear and culture. Four (57%) of the seven patients with non-diagnostic results had positive TB-PCR results, and anti-tuberculosis treatment led to clinical and radiological improvement in all of the patients.
  
  
  CONCLUSIONS
  TB-PCR using EBUS-TBNA samples is a useful laboratory test for diagnosing IGL. Moreover, this technique can prevent further invasive evaluation in patients whose histological and microbiological tests are non-diagnostic.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. ejspulm@gmail.com.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. ejspulm@gmail.com.
authors.forename: Jung Seop
authors.initials: JS
authors.lastname: Eom
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. mokgamokga@gmail.com.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. mokgamokga@gmail.com.
authors.forename: Jeong Ha
authors.initials: JH
authors.lastname: Mok
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. leemk@pusan.ac.kr.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. leemk@pusan.ac.kr.
authors.forename: Min Ki
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. medicum@daum.net.
authors.forename: Kwangha
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. warmgalaxy@hanmail.net.
authors.forename: Min Ji
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. 15rain@hanmail.net.
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. nh0204@hanmail.net.
authors.forename: Hae Jung
authors.initials: HJ
authors.lastname: Na
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. xelloss2015@hanmail.net.
authors.forename: Seung Eon
authors.initials: SE
authors.lastname: Song
authors.affiliation: Department of Radiology, Pusan National University School of Medicine, Busan, Korea. rabkingdom@naver.com.
authors.forename: Geewon
authors.initials: G
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. 81goodjung@daum.net.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Jo
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. lovefull777@naver.com.
authors.forename: Mi-Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. uk303@hanmail.net.
authors.forename: Ki Uk
authors.initials: KU
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. irisal@hanmail.net.
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Park
mesh_terms: D000328:Adult; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis*