Real time endobronchial ultrasound transbronchial needle aspiration for the diagnosis of tuberculous intrathoracic lymphadenopathy Saudi Arabian Western region experience

• Published in: Saudi medical journal Vol. 44; no. 2; pp. 178 - 186
• Main Author: Aljohaney, Ahmed A.
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Saudi Medical Journal 01.02.2023
• Subjects: Biopsy, Needle; Diagnosis; Endoscopic ultrasonography; Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods; Humans; Lymph node tuberculosis; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphadenopathy - diagnosis; Lymphadenopathy - pathology; Methods; Mycobacterium tuberculosis; Original; Retrospective Studies; Saudi Arabia; Tuberculin; Tuberculosis, Lymph Node - diagnosis; Tuberculosis, Lymph Node - pathology; Saudi Arabia; thorax; efficiency; lymph nodes; ultrasonography; safety; endoscopes; mediastinum
• ISSN: 0379-5284; 1658-3175
• DOI: 10.15537/smj.2023.44.2.20220434

To assess the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for presumptive tuberculosis (TB) patients with intrathoracic enlarged lymph nodes in a country with low to moderate TB incidence. Thirty-one patients with clinical features of TB and intrathoracic lymphadenopathy, who had EBUS-TBNA sampling and final confirmation of intrathoracic TB lymphadenopathy, were retrospectively reviewed over an 8-year period. Routine clinical and laboratory evaluations including computerized tomography scans were performed before the EBUS-TBNA. Sociodemographic characteristics, clinical profile, pathological, and microbiological findings were collected. The EBUS-TBNA confirmed TB diagnosis in 26 (83.9%) subjects with a consistent pathological finding or positive culture of . Pathological analysis had findings consistent with TB in 25 (80.6%) patients. Culture of the EBUS-TBNA sample was positive for in 12 (38.7%) patients. Other supportive investigations like purified protein derivative (PPD) skin test was positive in 28 (90.3%) participants. Overall, the sensitivity of the EBUS-TBNA alone was 83.9%. No complications were recorded during the procedure. The EBUS-TBNA aspirate culture positivity was significantly related to having a larger size lymph node ( =0.048) only, while PPD positivity was significantly related to baseline and clinical features of the participants. The EBUS-TBNA demonstrated effective utility and safety in the evaluation and diagnosis of intrathoracic TB lymphadenopathy among individuals with compatible symptoms in a country with low-moderate TB-incidence.