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The value of rapid on-site evaluation during endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal lesions

Egyptian Journal of Bronchology volume 11, pages 336–341 (2017)Cite this article

Abstract

Introduction

Rapid on-site evaluation (ROSE) is a technique used for immediate interpretation of transbronchial aspirates; there is debate as regards the contribution of ROSE to the diagnostic or staging process in patients with lung cancer undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).

Aim of the study

The aim of this study was to evaluate the role of ROSE during EBUS-guided TBNA in the diagnosis of the nature of mediastinal/hilar lesions detected using thoracic computed tomography regardless of whether or not there is a known lung malignancy.

Patients and methods

All patients with hilar/mediastinal lymph nodes having short axis of at least 1 cmon new thoracic computed tomography scan were included. The target lymph node was examined using real-time EBUS B-mode, and then TBNA was performed by inserting a dedicated 22-G needle through the working channel of the bronchoscopy. The samples were examined using the ROSE technique and then compared with the results of the final pathologic diagnosis.

Results

The current study was conducted on 47 patients (29 male and 18 female) with a age (mean±SD) of 56±15.4 years. EBUS-TBNA was performed for 129 mediastinal lesions in different stations. Among them, 77 of them were diagnosed as malignant initially on performing ROSE. After final histopathological and immunological examination, 74 lesions were proved to be malignant, whereas three lesions turned out to be benign. 52 lesions were diagnosed as benign on ROSE, whereas four of them were proved to be malignant on the final diagnosis, giving ROSE a specificity of 94.12%, sensitivity of 94.87%, and diagnostic accuracy of 94.57%.

Conclusion

ROSE has add-on advantages to EBUS-TBNA in many aspects, increasing diagnostic accuracy of EBUS-TBNA, increasing safety, and providing sufficient samples for subsequent immunocytochemical and molecular analysis.

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Authors and Affiliations

  1. Departments of Chest Diseases, Tanta University Hospital, Tanta, 33633, Egypt

    Adel S. Bediwy MD, Mohamed Hantira & Dalia El-Sharawy

  2. Pathology, Faculty of Medicine, Tanta University, Cairo, Egypt

    Ayman ElSaqa & Yomna Zamzam

  3. Kobry-ElKoba Military Hospitals, Cairo, Egypt

    Khaled Zamzam

Authors
  1. Adel S. Bediwy MD
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  2. Khaled Zamzam
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  3. Mohamed Hantira
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  4. Dalia El-Sharawy
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  5. Ayman ElSaqa
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  6. Yomna Zamzam
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Corresponding author

Correspondence to Adel S. Bediwy MD.

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Bediwy, A.S., Zamzam, K., Hantira, M. et al. The value of rapid on-site evaluation during endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal lesions. Egypt J Bronchol 11, 336–341 (2017). https://doi.org/10.4103/ejb.ejb_20_17

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  • DOI: https://doi.org/10.4103/ejb.ejb_20_17

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