title: Utility of endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing non-specific inflammatory intrathorcacic lymphadenitis.
abstract: OBJECTIVE
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a minimally invasive technique for diagnosing intrathoracic malignancies and some benignancies; however, there are no data available on the utility of EBUS-TBNA for the diagnosis of non-specific inflammatory intrathoracic lymphadenitis.
  
  
  METHODS
  A prospective analysis was performed from 104 patients with enlarged lymphadenopathy suspected of non-specific lymphadenitis referred for EBUS-TBNA between October 2009 and March 2012. Rapid on-site cytological evaluation was not adopted. Microbiological tests were carried out in all patients. Patients were excluded from the study if there was other diagnosis being defined.
  
  
  RESULTS
  One hundred ninety-one lesions were aspirated in 94 patients with enlarged mediastinal/hilar lymph nodes within reach of EBUS-TBNA, which were diagnosed as non-specific intrathorcacic lymphadenitis by pathology and clinical follow-up. According to EBUS-TBNA pathologies, 94 patients were categorized into four kinds: (i) inflammatory cell infiltrates and/or noncaseating necrosis in 38 cases; (ii) granuloma formed by epithelioid cells and/or fiber hyperplasia in 13 cases; (iii) lymph node tissue/lymphocyte without obvious abnormal lesions in 41 cases; (iv) inadequate sample in 2 cases. Bacterial and/or fungal smears and cultures were carried out in all 94 patients (100%), with pathogens being found in 4 (4.3%) cases. All patients (100%) underwent acid-fast staining and culture for mycobacterium tuberculosis to exclude tuberculosis. No procedure-related complication was observed.
  
  
  CONCLUSIONS
  EBUS-TBNA can provide pathological and microbiological evidences for diagnosing non-specific inflammatory intrathoracic lymphadenopathy, and it is a safe and effective first-line investigation for ruling out malignancies and other benign diseases.
authors.affiliation: Department of Endoscopy, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, People's Republic of China.|Department of Respiratory and Critical Care Medicine, People's Hospital of Zhengzhou University, Zhengzhou, 450003, People's Republic of China.
authors.forename: Huizhen
authors.identifier: http://orcid.org/0000-0002-6601-8022
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Pulmonary Medicine, First People's Hospital of Yunnan Province, Kunming, 650000, People's Republic of China.
authors.forename: Shenglan
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, People's Republic of China.
authors.forename: Jiajun
authors.initials: J
authors.lastname: Teng
authors.affiliation: Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, People's Republic of China.
authors.forename: Baohui
authors.initials: B
authors.lastname: Han
authors.affiliation: Department of Endoscopy, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, People's Republic of China.
authors.forename: Jiayuan
authors.initials: J
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001999:Bronchoscopy / Q000379:methods; D002681:China; D015331:Cohort Studies; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D007150:Immunohistochemistry; D008199:Lymphadenitis / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D061214:Patient Safety; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: endobronchial ultrasound (EBUS); intrathoracic lymphadenopathy; non-specific inflammation; pathology; transbronchial needle aspiration (TBNA)