Document Type : Original Article
Authors
1
Professor of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt;
2
Professor of Chest Diseases, Military Medical Academy, Cairo, Egypt;
3
Professor of Histopathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt;
4
Assistant Professor of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
5
MBBCh, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
https://doi.org/10.21608/aimj.2025.446634
Abstract
Background: Many different types of lymphadenopathies, both benign and malignant, can affect the mediastinum. Pathology is used to confirm the diagnosis. One minimally invasive method for diagnosing mediastinal and hilar diseases is TBNA, which stands for transbronchial needle aspiration. TBNA can be performed blindly or guided by endobronchial ultrasound, with the choice often depending on availability and operator preference.
Objective: In order to evaluate the relative merits of EBUS-TBNA and conventional TBNA for the diagnosis of mediastinal lymphadenopathy, we will be comparing the two procedures.
Patients and Methods: From February 2023 to February 2025, 40 patients referred to the Endoscopy Unit of the Chest Department at Al-Azhar University Hospitals and International Medical Center in Cairo were evaluated prospectively for undiagnosed mediastinal lymphadenopathy. Twenty patients each were assigned to group A (c-TBNA) and group B (EBUS-TBNA).
Results: There was no statistically significant difference in diagnostic yield between the two groups (P=0.288). In group A, 65% of patients were diagnosed, while 35% were not. In group B, 80% of patients were diagnosed, and 20% were not. Regarding the yield of biopsied subcarinal lymph nodes, there was no statistically significant difference (P=0.67) between the groups that were investigated. Results of biopsied LN from all stations except 7 showed a statistically significant difference (P=0.011) between the groups that were investigated. Regarding the occurrence of complications, there was no statistically significant difference (P=0.241) among the groups that were evaluated.
Conclusion: Minimally invasive techniques such as conventional and EBUS-guided TBNA are associated with lower patient risk and acceptable safety profiles. The results they give for benign and malignant growth of the mediastinal and/or hilar lymph nodes are substantial. Because of its higher diagnostic yield, particularly for lymph nodes outside of the subcarinal area, EBUS-TBNA is the gold standard for identifying unexplained mediastinal lymphadenopathy.
Keywords
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