title: Diagnostic value of core biopsy histology and cytology sampling of mediastinal lymph nodes using 21-gauge EBUS-TBNA needle.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the initial modality of choice in sampling mediastinal lymphadenopathy. It is possible to obtain both cytological and histological samples using both 21-gauge and 22-gauge EBUS-TBNA needles. The current study was undertaken to compare the diagnostic yield of cytology and histology samples obtained by the same EBUS-TBNA 21-gauge needle.
  
  
  METHODS
  One hundred sixty-six consecutive patients who underwent EBUS-TBNA with a 21-gauge EBUS-TBNA needle over a period of 3 years were included in this retrospective analysis. The diagnostic yields of EBUS-TBNA histology (EBUS-TBNA-H) and EBUS-TBNA cytology (EBUS-TBNA-C) specimens were compared using the McNemar test.
  
  
  RESULTS
  The overall sensitivity and specificity of EBUS-TBNA were 89% and 100%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of EBUS-TBNA were 100% and 53%, respectively. The overall sensitivity and specificity of EBUS-TBNA-H were 85% and 100%, respectively. The PPV and NPV of EBUS-TBNA-H were 100% and 43%, respectively. The overall sensitivity and specificity of EBUS-TBNA-C were 65% and 100%, respectively. The PPV and NPV of EBUS-TBNA-C were 100% and 14%, respectively. The diagnostic yield of EBUS-TBNA-H over EBUS-TBNA-C was statistically significant (P < 0.0001).
  
  
  CONCLUSIONS
  EBUS-TBNA-H with 21-gauge needle significantly improves the diagnostic yield of EBUS-TBNA. EBUS-TBNA-H improves the NPV of EBUS-TBNA. The combination of EBUS-TBNA-H and EBUS-TBNA-C improves the overall diagnostic yield of EBUS-TBNA.
authors.affiliation: Institute of Pulmonology, Medical Research and Development, Mumbai; Lung Care and Sleep Centre, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India.
authors.forename: Preyas J
authors.initials: PJ
authors.lastname: Vaidya
authors.affiliation: Institute of Pulmonology, Medical Research and Development, Mumbai, Maharashtra, India.
authors.forename: Avinandan
authors.initials: A
authors.lastname: Saha
authors.affiliation: Institute of Pulmonology, Medical Research and Development, Mumbai; Lung Care and Sleep Centre, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India.
authors.forename: Arvind H
authors.initials: AH
authors.lastname: Kate
authors.affiliation: Institute of Pulmonology, Medical Research and Development, Mumbai; Lung Care and Sleep Centre, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Pandey
authors.affiliation: Institute of Pulmonology, Medical Research and Development, Mumbai; Lung Care and Sleep Centre, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India.
authors.forename: Vinod B
authors.initials: VB
authors.lastname: Chavhan
authors.affiliation: Institute of Pulmonology, Medical Research and Development, Mumbai, Maharashtra, India.
authors.forename: Joerg D
authors.initials: JD
authors.lastname: Leuppi
authors.affiliation: Institute of Pulmonology, Medical Research and Development, Mumbai; Lung Care and Sleep Centre, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India.
authors.forename: Prashant N
authors.initials: PN
authors.lastname: Chhajed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000379:methods; D002648:Child; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000175:diagnosis; D008297:Male; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult