Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy: a multicentre study

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

doi:10.1136/thoraxjnl-2011-200063

Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy: a multicentre study

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

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Abstract

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as an important tool for the diagnosis and staging of lung cancer but its role in the diagnosis of tuberculous intrathoracic lymphadenopathy has not been established. The aim of this study was to describe the diagnostic utility of EBUS-TBNA in patients with intrathoracic lymphadenopathy due to tuberculosis (TB).

METHODS: 156 consecutive patients with isolated intrathoracic TB lymphadenitis were studied across four centres over a 2-year period. Only patients with a confirmed diagnosis or unequivocal clinical and radiological response to antituberculous treatment during follow-up for a minimum of 6 months were included. All patients underwent routine clinical assessment and a CT scan prior to EBUS-TBNA. Demographic data, HIV status, pathological findings and microbiological results were recorded.

RESULTS: EBUS-TBNA was diagnostic of TB in 146 patients (94%; 95% CI 88% to 97%). Pathological findings were consistent with TB in 134 patients (86%). Microbiological investigations yielded a positive culture of TB in 74 patients (47%) with a median time to positive culture of 16 days (range 3-84) and identified eight drug-resistant cases (5%). Ten patients (6%) did not have a specific diagnosis following EBUS; four underwent mediastinoscopy which confirmed the diagnosis of TB while six responded to empirical antituberculous therapy. There was one complication requiring an inpatient admission.

CONCLUSIONS: EBUS-TBNA is a safe and effective first-line investigation in patients with tuberculous intrathoracic lymphadenopathy.

Original language	English
Pages (from-to)	889-893
Number of pages	5
Journal	Thorax
Volume	66
Issue number	10
DOIs	https://doi.org/10.1136/thoraxjnl-2011-200063
Publication status	Published - Oct 2011

Keywords

Adolescent
Adult
Aged
Aged, 80 and over
Biopsy, Fine-Needle/methods
Bronchoscopy
Diagnosis, Differential
Endosonography/methods
Female
Follow-Up Studies
Humans
Lymph Nodes/diagnostic imaging
Male
Middle Aged
Mycobacterium tuberculosis/isolation & purification
Reproducibility of Results
Retrospective Studies
Thoracic Cavity
Tuberculosis, Lymph Node/diagnostic imaging
Young Adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/thoraxjnl-2011-200063

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Navani, N., Molyneaux, P. L., Breen, R. A., Connell, D. W., Jepson, A., Nankivell, M., Brown, J. M., Morris-Jones, S., Ng, B., Wickremasinghe, M., Lalvani, A., Rintoul, R. C., Santis, G., Kon, O. M., & Janes, S. M. (2011). Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy: a multicentre study. Thorax, 66(10), 889-893. https://doi.org/10.1136/thoraxjnl-2011-200063

@article{5164e88bd14f4fb1b18369ce82545b13,

title = "Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy: a multicentre study",

abstract = "BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as an important tool for the diagnosis and staging of lung cancer but its role in the diagnosis of tuberculous intrathoracic lymphadenopathy has not been established. The aim of this study was to describe the diagnostic utility of EBUS-TBNA in patients with intrathoracic lymphadenopathy due to tuberculosis (TB).METHODS: 156 consecutive patients with isolated intrathoracic TB lymphadenitis were studied across four centres over a 2-year period. Only patients with a confirmed diagnosis or unequivocal clinical and radiological response to antituberculous treatment during follow-up for a minimum of 6 months were included. All patients underwent routine clinical assessment and a CT scan prior to EBUS-TBNA. Demographic data, HIV status, pathological findings and microbiological results were recorded.RESULTS: EBUS-TBNA was diagnostic of TB in 146 patients (94%; 95% CI 88% to 97%). Pathological findings were consistent with TB in 134 patients (86%). Microbiological investigations yielded a positive culture of TB in 74 patients (47%) with a median time to positive culture of 16 days (range 3-84) and identified eight drug-resistant cases (5%). Ten patients (6%) did not have a specific diagnosis following EBUS; four underwent mediastinoscopy which confirmed the diagnosis of TB while six responded to empirical antituberculous therapy. There was one complication requiring an inpatient admission.CONCLUSIONS: EBUS-TBNA is a safe and effective first-line investigation in patients with tuberculous intrathoracic lymphadenopathy.",

keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, Fine-Needle/methods, Bronchoscopy, Diagnosis, Differential, Endosonography/methods, Female, Follow-Up Studies, Humans, Lymph Nodes/diagnostic imaging, Male, Middle Aged, Mycobacterium tuberculosis/isolation & purification, Reproducibility of Results, Retrospective Studies, Thoracic Cavity, Tuberculosis, Lymph Node/diagnostic imaging, Young Adult",

author = "Neal Navani and Molyneaux, {Philip L} and Breen, {Ronan A} and Connell, {David W} and Annette Jepson and Matthew Nankivell and Brown, {James M} and Stephen Morris-Jones and Benjamin Ng and Melissa Wickremasinghe and Ajit Lalvani and Rintoul, {Robert C} and George Santis and Kon, {Onn Min} and Janes, {Sam M}",

year = "2011",

month = oct,

doi = "10.1136/thoraxjnl-2011-200063",

language = "English",

volume = "66",

pages = "889--893",

journal = "Thorax",

issn = "0040-6376",

publisher = "BMJ Publishing Group",

number = "10",

}

Navani, N, Molyneaux, PL, Breen, RA, Connell, DW, Jepson, A, Nankivell, M, Brown, JM, Morris-Jones, S, Ng, B, Wickremasinghe, M, Lalvani, A, Rintoul, RC, Santis, G, Kon, OM & Janes, SM 2011, 'Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy: a multicentre study', Thorax, vol. 66, no. 10, pp. 889-893. https://doi.org/10.1136/thoraxjnl-2011-200063

TY - JOUR

T1 - Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy

T2 - a multicentre study

AU - Navani, Neal

AU - Molyneaux, Philip L

AU - Breen, Ronan A

AU - Connell, David W

AU - Jepson, Annette

AU - Nankivell, Matthew

AU - Brown, James M

AU - Morris-Jones, Stephen

AU - Ng, Benjamin

AU - Wickremasinghe, Melissa

AU - Lalvani, Ajit

AU - Rintoul, Robert C

AU - Santis, George

AU - Kon, Onn Min

AU - Janes, Sam M

PY - 2011/10

Y1 - 2011/10

N2 - BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as an important tool for the diagnosis and staging of lung cancer but its role in the diagnosis of tuberculous intrathoracic lymphadenopathy has not been established. The aim of this study was to describe the diagnostic utility of EBUS-TBNA in patients with intrathoracic lymphadenopathy due to tuberculosis (TB).METHODS: 156 consecutive patients with isolated intrathoracic TB lymphadenitis were studied across four centres over a 2-year period. Only patients with a confirmed diagnosis or unequivocal clinical and radiological response to antituberculous treatment during follow-up for a minimum of 6 months were included. All patients underwent routine clinical assessment and a CT scan prior to EBUS-TBNA. Demographic data, HIV status, pathological findings and microbiological results were recorded.RESULTS: EBUS-TBNA was diagnostic of TB in 146 patients (94%; 95% CI 88% to 97%). Pathological findings were consistent with TB in 134 patients (86%). Microbiological investigations yielded a positive culture of TB in 74 patients (47%) with a median time to positive culture of 16 days (range 3-84) and identified eight drug-resistant cases (5%). Ten patients (6%) did not have a specific diagnosis following EBUS; four underwent mediastinoscopy which confirmed the diagnosis of TB while six responded to empirical antituberculous therapy. There was one complication requiring an inpatient admission.CONCLUSIONS: EBUS-TBNA is a safe and effective first-line investigation in patients with tuberculous intrathoracic lymphadenopathy.

AB - BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as an important tool for the diagnosis and staging of lung cancer but its role in the diagnosis of tuberculous intrathoracic lymphadenopathy has not been established. The aim of this study was to describe the diagnostic utility of EBUS-TBNA in patients with intrathoracic lymphadenopathy due to tuberculosis (TB).METHODS: 156 consecutive patients with isolated intrathoracic TB lymphadenitis were studied across four centres over a 2-year period. Only patients with a confirmed diagnosis or unequivocal clinical and radiological response to antituberculous treatment during follow-up for a minimum of 6 months were included. All patients underwent routine clinical assessment and a CT scan prior to EBUS-TBNA. Demographic data, HIV status, pathological findings and microbiological results were recorded.RESULTS: EBUS-TBNA was diagnostic of TB in 146 patients (94%; 95% CI 88% to 97%). Pathological findings were consistent with TB in 134 patients (86%). Microbiological investigations yielded a positive culture of TB in 74 patients (47%) with a median time to positive culture of 16 days (range 3-84) and identified eight drug-resistant cases (5%). Ten patients (6%) did not have a specific diagnosis following EBUS; four underwent mediastinoscopy which confirmed the diagnosis of TB while six responded to empirical antituberculous therapy. There was one complication requiring an inpatient admission.CONCLUSIONS: EBUS-TBNA is a safe and effective first-line investigation in patients with tuberculous intrathoracic lymphadenopathy.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biopsy, Fine-Needle/methods

KW - Bronchoscopy

KW - Diagnosis, Differential

KW - Endosonography/methods

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Lymph Nodes/diagnostic imaging

KW - Male

KW - Middle Aged

KW - Mycobacterium tuberculosis/isolation & purification

KW - Reproducibility of Results

KW - Retrospective Studies

KW - Thoracic Cavity

KW - Tuberculosis, Lymph Node/diagnostic imaging

KW - Young Adult

U2 - 10.1136/thoraxjnl-2011-200063

DO - 10.1136/thoraxjnl-2011-200063

M3 - Article

C2 - 21813622

SN - 0040-6376

VL - 66

SP - 889

EP - 893

JO - Thorax

JF - Thorax

IS - 10

ER -

Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy: a multicentre study

Abstract

Keywords

UN SDGs

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