Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies

Jose Sanz-Santos, Beatriz Cirauqui, Estefania Sanchez, Felipe Andreo, Pere Serra, Eduard Monso, Eva Castellà, Mariona Llatjós, Miguel Mesa, Juan Ruiz-Manzano, Rafael Rosell

Research output: Contribution to journalArticleResearchpeer-review

26 Citations (Scopus)

Abstract

Intrathoracic lymph node enlargement is a common finding in patients with extrathoracic malignancies. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a technique that is commonly used for lung cancer diagnosis and staging but that has not been widely investigated for the diagnosis of enlarged mediastinal and lobar lymph nodes in patients with extrathoracic malignancies. We conducted a retrospective study of 117 patients with extrathoracic malignancies who underwent EBUS-TBNA for diagnosis of intrathoracic lymph node enlargement from October 2005 to December 2009 and compared the EBUS-TBNA findings with the final diagnoses. EBUS-TBNA diagnosed mediastinal metastases in 51 of the 117 (43.6 %) cases and gave an alternate diagnosis or ruled out the presence of malignancy in 35 (56.4 %). Fourteen of these 35 patients underwent further surgical investigation, while the remaining 21 had clinical and radiological follow-up for 18 months. No false negatives were found in the surgery group. In the follow-up group, 13 patients had stable or regressive lymphadenopathy, and eight developed clinicoradiological progression and were assumed to have been false negatives by EBUS-TBNA. The sensitivity and negative predictive value of EBUS-TBNA were 86.4 and 75 %, respectively. Immunohistochemical staining (IHC) was performed in 80.4 % of the samples obtained by EBUS-TBNA. In samples obtained from ten patients with metastatic breast cancer, estrogen receptor expression was successfully assessed in eight patients and progesterone receptor and human epidermal growth factor receptor 2 in four. EBUS-TBNA is an accurate procedure for the diagnosis of thoracic lymph node metastases in patients with extrathoracic malignancies and should be an initial diagnostic tool in these patients. Furthermore, EBUS-TBNA can obtain high-quality specimens from metastatic lymph nodes for use in molecular analyses. © 2012 The Author(s).
Original languageEnglish
Pages (from-to)521-528
JournalClinical and Experimental Metastasis
Volume30
Issue number4
DOIs
Publication statusPublished - 1 Apr 2013

Keywords

  • EBUS-TBNA
  • Endobronchial ultrasound
  • Extrathoracic malignancy
  • Immunohistochemistry
  • Mediastinal lymph node metastases
  • Transbronchial needle aspiration

Fingerprint Dive into the research topics of 'Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies'. Together they form a unique fingerprint.

Cite this