Predictive Value of Endobronchial Sonographic Patterns in Diagnosis of Mediastinal Lymphadenopathy

Predictive Value of Endobronchial Sonographic Patterns in Diagnosis of Mediastinal Lymphadenopathy

This study aims to assess the value of endosonographic patterns of EBUS bronchoscopy in diagnosis of patients with mediastinal lymphadenopathy and correlate it with the histopathological diagnosis.

All patients will undergo EBUS-bronchoscopy using 22-gauge needle of EBUS.

• Lymph node stations and numbers were determined according to the International Association for the Study of Lung Cancer classification.
• Systemic evaluation of Lymph nodes according to ERS guidelines starting with any potential N3 lymph nodes followed by N2 lymph nodes, and N1 lymph nodes Ultrasound features of suspected lymph nodes were categorized according to: B-mode, Color Power Doppler Index (CPDI) After evaluation of ultrasound features, a TBNA using a 22- G needle were performed. Three samples were taken from each node or lesion for +/- rapid on-site evaluation ROSE (using Haematoxylin and Eosin stain) and histopathological examination.

Inclusion Criteria:

• Age ≥ 18 years.
• patients who underwent chest enhanced CT before EBUS-TBNA examination to assess the nature of mediastinal and hilar enlarged lymph nodes.

Exclusion Criteria:

• Contraindication to needle biopsy (e.g. use of anticoagulation drugs, bleeding diathesis).
• Patients unfit for bronchoscopy and general anaesthesia by international guidelines.
• Lymph Nodes that are not accessible or technically difficult by EBUS-TBNA e.g. Station 5,6.