BACKGROUND: EUS-guided FNA (EUS-FNA) or trucut biopsy (TCB) is indispensible in the diagnosis of mediastinal malignancies. Less is known, however, about the usefulness of EUS-guided sampling for nonmalignant, mediastinal tuberculosis (TB), despite the increase in the incidence of TB. OBJECTIVE: To assess the diagnostic yields of EUS-FNA/TCB in patients with mediastinal TB. DESIGN: Retrospective study. SETTING: Tertiary-care referral hospital in a geographic region with an intermediate TB burden. PATIENTS: This study involved 24 consecutive patients with mediastinal TB, who underwent EUS-FNA/TCB from July 2005 to September 2008. INTERVENTION: EUS-FNA/TCB. MAIN OUTCOME MEASUREMENTS: Technical success and diagnostic yields of EUS-FNA/TCB. RESULTS: Mediastinal lesions (mean diameter, 28.6 mm; range 17.0-49.5 mm) were targeted by using 22-gauge-needle FNA in 10 patients and 19-gauge-needle TCB in 14 patients. Before EUS, only 10 of the 24 patients had a presumptive diagnosis of mediastinal TB, whereas 11 patients were suspected of having malignancies. Six patients showed mass-like lung parenchymal lesions mimicking lung cancer, and 7 patients had a history of malignancy. Pathologic examination showed granulomatous inflammation in 16 patients (66.7%), including 10 patients with caseating granulomas. Positive microbiologic results were obtained in 10 patients (41.7%): 3 by Ziehl-Neelsen staining, 5 by Mycobacterium tuberculosis culture, and 5 by TB polymerase chain reaction (PCR) assay. EUS-FNA/TCB confirmed mediastinal TB in 20 of the 24 patients and directed 11 patients clinically suspected of having malignancies to anti-TB treatment. The diagnostic yields of FNA and TCB were similar (90.0% vs 78.6%). LIMITATIONS: Retrospective design in a tertiary-care referral hospital. CONCLUSION: EUS-FNA/TCB is sufficiently useful to confirm mediastinal TB and can exclude suspected malignancies in TB patients. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
BACKGROUND: EUS-guided FNA (EUS-FNA) or trucut biopsy (TCB) is indispensible in the diagnosis of mediastinal malignancies. Less is known, however, about the usefulness of EUS-guided sampling for nonmalignant, mediastinal tuberculosis (TB), despite the increase in the incidence of TB. OBJECTIVE: To assess the diagnostic yields of EUS-FNA/TCB in patients with mediastinal TB. DESIGN: Retrospective study. SETTING: Tertiary-care referral hospital in a geographic region with an intermediate TB burden. PATIENTS: This study involved 24 consecutive patients with mediastinal TB, who underwent EUS-FNA/TCB from July 2005 to September 2008. INTERVENTION: EUS-FNA/TCB. MAIN OUTCOME MEASUREMENTS: Technical success and diagnostic yields of EUS-FNA/TCB. RESULTS: Mediastinal lesions (mean diameter, 28.6 mm; range 17.0-49.5 mm) were targeted by using 22-gauge-needle FNA in 10 patients and 19-gauge-needle TCB in 14 patients. Before EUS, only 10 of the 24 patients had a presumptive diagnosis of mediastinal TB, whereas 11 patients were suspected of having malignancies. Six patients showed mass-like lung parenchymal lesions mimicking lung cancer, and 7 patients had a history of malignancy. Pathologic examination showed granulomatous inflammation in 16 patients (66.7%), including 10 patients with caseating granulomas. Positive microbiologic results were obtained in 10 patients (41.7%): 3 by Ziehl-Neelsen staining, 5 by Mycobacterium tuberculosis culture, and 5 by TB polymerase chain reaction (PCR) assay. EUS-FNA/TCB confirmed mediastinal TB in 20 of the 24 patients and directed 11 patients clinically suspected of having malignancies to anti-TB treatment. The diagnostic yields of FNA and TCB were similar (90.0% vs 78.6%). LIMITATIONS: Retrospective design in a tertiary-care referral hospital. CONCLUSION:EUS-FNA/TCB is sufficiently useful to confirm mediastinal TB and can exclude suspected malignancies in TB patients. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Authors: Hee Kyong Na; Jeong Hoon Lee; Young Soo Park; Ji Yong Ahn; Kwi-Sook Choi; Do Hoon Kim; Kee Don Choi; Ho June Song; Gin Hyug Lee; Hwoon-Yong Jung; Jin-Ho Kim Journal: Clin Endosc Date: 2015-03-27
Authors: Neal Navani; Philip L Molyneaux; Ronan A Breen; David W Connell; Annette Jepson; Matthew Nankivell; James M Brown; Stephen Morris-Jones; Benjamin Ng; Melissa Wickremasinghe; Ajit Lalvani; Robert C Rintoul; George Santis; Onn Min Kon; Sam M Janes Journal: Thorax Date: 2011-08-03 Impact factor: 9.139