Sahajal Dhooria1, Karan Madan2, Vallandramam Pattabhiraman3, Inderpaul Singh Sehgal1, Ravindra Mehta4, Gella Vishwanath5, Arjun Srinivasan3, Mahadevan Sivaramakrishnan3, Anant Mohan2, Joseph L Mathew6, Sushil K Kabra7, Randeep Guleria2, Digambar Behera1, Ritesh Agarwal8. 1. Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 2. Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India. 3. Kovai Medical Center, Coimbatore, India. 4. Apollo Hospitals, Bengaluru, India. 5. Institute of Pulmonary and Sleep Disorders, Continental Hospitals, Hyderabad, India. 6. Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 7. Pediatric Pulmonology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. 8. Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. agarwal.ritesh@outlook.in.
Abstract
BACKGROUND AND AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND AND AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: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.
Authors: Gaetano Rea; Marco Sperandeo; Roberta Lieto; Marialuisa Bocchino; Carla Maria Irene Quarato; Beatrice Feragalli; Tullio Valente; Giulia Scioscia; Ernesto Giuffreda; Maria Pia Foschino Barbaro; Donato Lacedonia Journal: Front Med (Lausanne) Date: 2021-12-10