Roberto Chalela1, Albert Sánchez-Font2, Marisol Domínguez-Álvarez2, Diana Badenes-Bonet3, Lara Pijuan4, Víctor Curull2. 1. Servei de Pneumologia, Hospital del Mar-Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, España; Hospital del Mar Medical Research Institute (IMIM), Barcelona, España; Universidad Pompeu Fabra, Barcelona, España. Electronic address: RChalela@parcdesalutmar.cat. 2. Servei de Pneumologia, Hospital del Mar-Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, España; Hospital del Mar Medical Research Institute (IMIM), Barcelona, España. 3. Hospital del Mar Medical Research Institute (IMIM), Barcelona, España. 4. Hospital del Mar Medical Research Institute (IMIM), Barcelona, España; Servei d'Anatomia Patològica, Hospital del Mar-Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, España.
Abstract
INTRODUCTION: Mediastinal tuberculosis (TB) is rare and a diagnostic challenge. Transbronchial needle aspiration guided by endoscopic ultrasonography (EBUS-TBNA) is an essential tool for staging and diagnosing patients with lung cancer but to date there are no studies in our environment evaluating its efficacy in mediastinal TB. METHODS: Patients with a final diagnosis of isolated intrathoracic tuberculous lymphadenitis over a 6-year period were included. We analyzed the cases on whom EBUS-TBNA was performed. RESULTS: Forty-six patients with mediastinal lymphadenopathy without pulmonary involvement were identified and 29 underwent EBUS-TBNA. In 28 of 29 patients (96.6%) EBUS-TBNA was diagnostic and cytological findings confirmed granulomas in 93% of cases. Microbiological investigation revealed positive TB culture in 14 (48.2%) and positive PCR for Mycobacterium tuberculosis in 30% of cases on whom it was carried out. Eighty-four per cent of the patients were immigrants and when compared with the native population we found statistical differences in immune status and culture yield. CONCLUSION: EBUS-TBNA is a safe and effective technique in the diagnosis of patients with suspected mediastinal TB.
INTRODUCTION:Mediastinal tuberculosis (TB) is rare and a diagnostic challenge. Transbronchial needle aspiration guided by endoscopic ultrasonography (EBUS-TBNA) is an essential tool for staging and diagnosing patients with lung cancer but to date there are no studies in our environment evaluating its efficacy in mediastinal TB. METHODS:Patients with a final diagnosis of isolated intrathoracic tuberculous lymphadenitis over a 6-year period were included. We analyzed the cases on whom EBUS-TBNA was performed. RESULTS: Forty-six patients with mediastinal lymphadenopathy without pulmonary involvement were identified and 29 underwent EBUS-TBNA. In 28 of 29 patients (96.6%) EBUS-TBNA was diagnostic and cytological findings confirmed granulomas in 93% of cases. Microbiological investigation revealed positive TB culture in 14 (48.2%) and positive PCR for Mycobacterium tuberculosis in 30% of cases on whom it was carried out. Eighty-four per cent of the patients were immigrants and when compared with the native population we found statistical differences in immune status and culture yield. CONCLUSION: EBUS-TBNA is a safe and effective technique in the diagnosis of patients with suspected mediastinal TB.