title: A multicenter study on the utility and safety of EBUS-TBNA and EUS-B-FNA in children.
abstract: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound with an echobronchoscope-guided fine needle aspiration (EUS-B-FNA) are useful modalities in the evaluation of mediastinal lymphadenopathy in adults; however, there is sparse data in children. The aim of this multicenter study is to describe the efficacy and safety of EBUS-TBNA and EUS-B-FNA in children with mediastinal lymphadenopathy of undefined etiology.
  
  
  
  Retrospective analysis of consecutive pediatric (<18 years) subjects who underwent EBUS-TBNA or EUS-B-FNA for the evaluation of mediastinal lymphadenopathy. The demographic characteristics, indications, procedural details, pathological, cytological and microbiological diagnosis, diagnostic yield, and complications are presented.
  
  
  
  Of the 3,424 EBUS/EUS-B-FNA procedures, 67 (1.9%) were performed in the pediatric (3-17 years) population. Of these, 19 (28.4%) were performed in children ≤12 years of age. Overall, EBUS-TBNA and EUS-B-FNA were performed in 53 and 12 subjects, respectively. In two subjects, no significant lymph node was seen on EBUS. The procedure was performed under moderate sedation in spontaneously breathing subjects in 54 (80.6%) instances. An adequate sample was obtained in 60 (92.3%) subjects while a diagnostic sample was obtained in 37 (56.9%) of the 65 subjects. The diagnostic yield was not significantly different (P = 0.59) between EBUS-TBNA (58.5%) and EUS-B-FNA (50%). The sensitivity of EBUS-TBNA/EUS-B-FNA was 79.1% and led to a change in diagnosis in 28 (41.8%) subjects. Complications, all minor were encountered in six (8.9%) subjects.
  
  
  
  EBUS-TBNA and EUS-B-FNA are safe techniques with a good diagnostic yield in the evaluation of children with mediastinal lymphadenopathy. Pediatr Pulmonol. 2016;51:1031-1039. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sahajal
authors.initials: S
authors.lastname: Dhooria
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Karan
authors.initials: K
authors.lastname: Madan
authors.affiliation: Kovai Medical Center, Coimbatore, India.
authors.forename: Vallandramam
authors.initials: V
authors.lastname: Pattabhiraman
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Inderpaul Singh
authors.initials: IS
authors.lastname: Sehgal
authors.affiliation: Apollo Hospitals, Bengaluru, India.
authors.forename: Ravindra
authors.initials: R
authors.lastname: Mehta
authors.affiliation: Institute of Pulmonary and Sleep Disorders, Continental Hospitals, Hyderabad, India.
authors.forename: Gella
authors.initials: G
authors.lastname: Vishwanath
authors.affiliation: Kovai Medical Center, Coimbatore, India.
authors.forename: Arjun
authors.initials: A
authors.lastname: Srinivasan
authors.affiliation: Kovai Medical Center, Coimbatore, India.
authors.forename: Mahadevan
authors.initials: M
authors.lastname: Sivaramakrishnan
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Anant
authors.initials: A
authors.lastname: Mohan
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Mathew
authors.affiliation: Pediatric Pulmonology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sushil K
authors.initials: SK
authors.lastname: Kabra
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Randeep
authors.initials: R
authors.lastname: Guleria
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Digambar
authors.initials: D
authors.lastname: Behera
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. agarwal.ritesh@outlook.in.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Agarwal
mesh_terms: D001999:Bronchoscopy / Q000379:methods; D002648:Child; D016292:Procedural Sedation; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies
keywords: ebus; endobronchial ultrasound; endoscopic ultrasound; eus; lymphoma; sarcoidosis; tuberculosis