The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience
AimTo assess the diagnostic role of endobronchial ultrasound (EBUS) guided transbronchial fine needle aspiration (TBNA) cytology, in the investigation of mediastinal lymphadenopathy and masses, with emphasis on pathology, criteria for adequacy, and use of liquid based cytology (LBC).MethodsIn Januar...
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| Veröffentlicht in: | Journal of clinical pathology 2010-05, Vol.63 (5), p.445-451 |
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| creator | Natu, S Hoffman, J Siddiqui, M Hobday, C Shrimankar, J Harrison, R |
| description | AimTo assess the diagnostic role of endobronchial ultrasound (EBUS) guided transbronchial fine needle aspiration (TBNA) cytology, in the investigation of mediastinal lymphadenopathy and masses, with emphasis on pathology, criteria for adequacy, and use of liquid based cytology (LBC).MethodsIn January 2008, EBUS guided TBNA was introduced for the staging of lung cancers and for the investigation of unexplained mediastinal lymphadenopathy and masses. Initially, the material was processed conventionally. In May 2008, the laboratory procured the Cytyc T2000.Results250 specimens (229 patients) were included from January 2008 to August 2009. The overall inadequate rate was 12%; 16.6% with the conventional method, 17.2% when both conventional and LBC were used, and 9.8% with LBC. With the conventional method, an average of 7.5 slides and one cell block were received per case. With LBC, one slide and one cell block were used for diagnosis. In 72 cases (28.8%) the aspirate showed no evidence of malignancy. In 122 cases (48.8%), there was metastatic disease. In five cases (2%), a diagnosis of atypia, suspicious for non-small cell malignancy, was made. One case (0.4%) each of amyloidosis and mediastinal goitre, 3 cases (1.2%) of lymphoma, 14 cases (5.6%) of sarcoidosis and 1 case (0.4%) each of sarcoma and mesothelioma were seen.ConclusionsEBUS guided TBNA, in our experience, is a reliable technique for staging of lung cancers, and investigation of unexplained mediastinal lymphadenopathy and masses. LBC reduces the number of slides from 7.5 per case to 1 slide, reducing time required for diagnosis. |
| doi_str_mv | 10.1136/jcp.2009.074328 |
| format | Article |
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Initially, the material was processed conventionally. In May 2008, the laboratory procured the Cytyc T2000.Results250 specimens (229 patients) were included from January 2008 to August 2009. The overall inadequate rate was 12%; 16.6% with the conventional method, 17.2% when both conventional and LBC were used, and 9.8% with LBC. With the conventional method, an average of 7.5 slides and one cell block were received per case. With LBC, one slide and one cell block were used for diagnosis. In 72 cases (28.8%) the aspirate showed no evidence of malignancy. In 122 cases (48.8%), there was metastatic disease. In five cases (2%), a diagnosis of atypia, suspicious for non-small cell malignancy, was made. One case (0.4%) each of amyloidosis and mediastinal goitre, 3 cases (1.2%) of lymphoma, 14 cases (5.6%) of sarcoidosis and 1 case (0.4%) each of sarcoma and mesothelioma were seen.ConclusionsEBUS guided TBNA, in our experience, is a reliable technique for staging of lung cancers, and investigation of unexplained mediastinal lymphadenopathy and masses. LBC reduces the number of slides from 7.5 per case to 1 slide, reducing time required for diagnosis.</description><identifier>ISSN: 0021-9746</identifier><identifier>EISSN: 1472-4146</identifier><identifier>DOI: 10.1136/jcp.2009.074328</identifier><identifier>PMID: 20299387</identifier><identifier>CODEN: JCPAAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Association of Clinical Pathologists</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biopsy, Fine-Needle - methods ; Cellular biology ; cytopathology ; EBUS ; endoscopic ultrasound ; Female ; Histology ; histopathology ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Lung cancer ; Lung Neoplasms - pathology ; lymph node pathology ; Lymphatic Diseases - diagnostic imaging ; Lymphatic Diseases - pathology ; Lymphatic Metastasis ; Lymphatic system ; Lymphoma ; Male ; Mediastinum ; Medical imaging ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; TBNA ; Ultrasonic imaging ; Ultrasonography, Interventional - methods ; Young Adult</subject><ispartof>Journal of clinical pathology, 2010-05, Vol.63 (5), p.445-451</ispartof><rights>2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2010 (c) 2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b493t-7cb995687a215ee8e76ef0c14db02f0e8ba496e40413442bf1e3b171c47987263</citedby><cites>FETCH-LOGICAL-b493t-7cb995687a215ee8e76ef0c14db02f0e8ba496e40413442bf1e3b171c47987263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jcp.bmj.com/content/63/5/445.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jcp.bmj.com/content/63/5/445.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,778,782,3185,23554,27907,27908,77351,77382</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22702042$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20299387$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Natu, S</creatorcontrib><creatorcontrib>Hoffman, J</creatorcontrib><creatorcontrib>Siddiqui, M</creatorcontrib><creatorcontrib>Hobday, C</creatorcontrib><creatorcontrib>Shrimankar, J</creatorcontrib><creatorcontrib>Harrison, R</creatorcontrib><title>The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience</title><title>Journal of clinical pathology</title><addtitle>J Clin Pathol</addtitle><description>AimTo assess the diagnostic role of endobronchial ultrasound (EBUS) guided transbronchial fine needle aspiration (TBNA) cytology, in the investigation of mediastinal lymphadenopathy and masses, with emphasis on pathology, criteria for adequacy, and use of liquid based cytology (LBC).MethodsIn January 2008, EBUS guided TBNA was introduced for the staging of lung cancers and for the investigation of unexplained mediastinal lymphadenopathy and masses. Initially, the material was processed conventionally. In May 2008, the laboratory procured the Cytyc T2000.Results250 specimens (229 patients) were included from January 2008 to August 2009. The overall inadequate rate was 12%; 16.6% with the conventional method, 17.2% when both conventional and LBC were used, and 9.8% with LBC. With the conventional method, an average of 7.5 slides and one cell block were received per case. With LBC, one slide and one cell block were used for diagnosis. In 72 cases (28.8%) the aspirate showed no evidence of malignancy. In 122 cases (48.8%), there was metastatic disease. In five cases (2%), a diagnosis of atypia, suspicious for non-small cell malignancy, was made. One case (0.4%) each of amyloidosis and mediastinal goitre, 3 cases (1.2%) of lymphoma, 14 cases (5.6%) of sarcoidosis and 1 case (0.4%) each of sarcoma and mesothelioma were seen.ConclusionsEBUS guided TBNA, in our experience, is a reliable technique for staging of lung cancers, and investigation of unexplained mediastinal lymphadenopathy and masses. LBC reduces the number of slides from 7.5 per case to 1 slide, reducing time required for diagnosis.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biopsy, Fine-Needle - methods</subject><subject>Cellular biology</subject><subject>cytopathology</subject><subject>EBUS</subject><subject>endoscopic ultrasound</subject><subject>Female</subject><subject>Histology</subject><subject>histopathology</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - pathology</subject><subject>lymph node pathology</subject><subject>Lymphatic Diseases - diagnostic imaging</subject><subject>Lymphatic Diseases - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Lymphoma</subject><subject>Male</subject><subject>Mediastinum</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>TBNA</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Interventional - methods</subject><subject>Young Adult</subject><issn>0021-9746</issn><issn>1472-4146</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkV-L1DAUxYso7rj67JsERASxs_k3TfMog67CMIKMIr6ENL2dZmyTbtLKzqfyK27Wjrvgi08hub9z7r05Wfac4CUhrLg4mGFJMZZLLDij5YNsQbigOSe8eJgtMKYkl4IXZ9mTGA8YEyYIe5ydUUylZKVYZL93LaDgO0C-QeBqXwXvTGt1h6ZuDDr6ydVoP9kaapTuLt4DDqBOQh0HG_RovUPmOPrO74_IOjQmY-t-QRztfq6mDj3UVqcXl-TdsR9aXYPzgx7bI9KpUa9jhPj2j3jrw9iiHUBEcD1AsOAMPM0eNbqL8Ox0nmdfP7zfrT_mm8-Xn9bvNnnFJRtzYSopV0UpNCUrgBJEAQ02hNcVpg2GstJcFsAxJ4xzWjUEWEUEMVzIUtCCnWevZ98h-KspLaF6Gw10nXbgp6gEY5JQKVaJfPkPefBTSAtGRURJsBSCikRdzJQJPsYAjRqC7XU4KoLVbZQqRaluo1RzlEnx4uQ7Venb7vi_2SXg1QnQ0eiuSeEYG-85KjDFnCYunzkbR7i-q-vwUxWCiZXaflsrvtkWfP3lu_qR-DczX_WH_055A0Q1xsQ</recordid><startdate>20100501</startdate><enddate>20100501</enddate><creator>Natu, S</creator><creator>Hoffman, J</creator><creator>Siddiqui, M</creator><creator>Hobday, C</creator><creator>Shrimankar, J</creator><creator>Harrison, R</creator><general>BMJ Publishing Group Ltd and Association of Clinical Pathologists</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20100501</creationdate><title>The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience</title><author>Natu, S ; Hoffman, J ; Siddiqui, M ; Hobday, C ; Shrimankar, J ; Harrison, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b493t-7cb995687a215ee8e76ef0c14db02f0e8ba496e40413442bf1e3b171c47987263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biopsy, Fine-Needle - methods</topic><topic>Cellular biology</topic><topic>cytopathology</topic><topic>EBUS</topic><topic>endoscopic ultrasound</topic><topic>Female</topic><topic>Histology</topic><topic>histopathology</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - pathology</topic><topic>lymph node pathology</topic><topic>Lymphatic Diseases - diagnostic imaging</topic><topic>Lymphatic Diseases - pathology</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Lymphoma</topic><topic>Male</topic><topic>Mediastinum</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>TBNA</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Interventional - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Natu, S</creatorcontrib><creatorcontrib>Hoffman, J</creatorcontrib><creatorcontrib>Siddiqui, M</creatorcontrib><creatorcontrib>Hobday, C</creatorcontrib><creatorcontrib>Shrimankar, J</creatorcontrib><creatorcontrib>Harrison, R</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Natu, S</au><au>Hoffman, J</au><au>Siddiqui, M</au><au>Hobday, C</au><au>Shrimankar, J</au><au>Harrison, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience</atitle><jtitle>Journal of clinical pathology</jtitle><addtitle>J Clin Pathol</addtitle><date>2010-05-01</date><risdate>2010</risdate><volume>63</volume><issue>5</issue><spage>445</spage><epage>451</epage><pages>445-451</pages><issn>0021-9746</issn><eissn>1472-4146</eissn><coden>JCPAAK</coden><abstract>AimTo assess the diagnostic role of endobronchial ultrasound (EBUS) guided transbronchial fine needle aspiration (TBNA) cytology, in the investigation of mediastinal lymphadenopathy and masses, with emphasis on pathology, criteria for adequacy, and use of liquid based cytology (LBC).MethodsIn January 2008, EBUS guided TBNA was introduced for the staging of lung cancers and for the investigation of unexplained mediastinal lymphadenopathy and masses. Initially, the material was processed conventionally. In May 2008, the laboratory procured the Cytyc T2000.Results250 specimens (229 patients) were included from January 2008 to August 2009. The overall inadequate rate was 12%; 16.6% with the conventional method, 17.2% when both conventional and LBC were used, and 9.8% with LBC. With the conventional method, an average of 7.5 slides and one cell block were received per case. With LBC, one slide and one cell block were used for diagnosis. In 72 cases (28.8%) the aspirate showed no evidence of malignancy. In 122 cases (48.8%), there was metastatic disease. In five cases (2%), a diagnosis of atypia, suspicious for non-small cell malignancy, was made. One case (0.4%) each of amyloidosis and mediastinal goitre, 3 cases (1.2%) of lymphoma, 14 cases (5.6%) of sarcoidosis and 1 case (0.4%) each of sarcoma and mesothelioma were seen.ConclusionsEBUS guided TBNA, in our experience, is a reliable technique for staging of lung cancers, and investigation of unexplained mediastinal lymphadenopathy and masses. LBC reduces the number of slides from 7.5 per case to 1 slide, reducing time required for diagnosis.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Association of Clinical Pathologists</pub><pmid>20299387</pmid><doi>10.1136/jcp.2009.074328</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Biopsy, Fine-Needle - methods Cellular biology cytopathology EBUS endoscopic ultrasound Female Histology histopathology Humans Investigative techniques, diagnostic techniques (general aspects) Lung cancer Lung Neoplasms - pathology lymph node pathology Lymphatic Diseases - diagnostic imaging Lymphatic Diseases - pathology Lymphatic Metastasis Lymphatic system Lymphoma Male Mediastinum Medical imaging Medical sciences Middle Aged Neoplasm Staging Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques TBNA Ultrasonic imaging Ultrasonography, Interventional - methods Young Adult |
| title | The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience |
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