Abstract Background Lymphadenopathy in patients with extrapulmonary neoplasms frequently indicates metastatic dissemination, but it may also occur in the context of inflammatory and infectious granulomatous diseases. Invasive sampling of mediastinal lymph nodes can be conducted through surgical techniques like mediastinoscopy or by Endobronchial Ultrasound with Fine Needle Aspiration (EBUS-TBNA). Objective Evaluate the effectiveness of EBUS-TBNA in the diagnosis of mediastinal and hilar lymphadenopathy in individuals with extrapulmonary malignancies, and to ascertain its sensitivity, specificity, and positive and negative predictive values. Methods Retrospective analysis of a prospectively maintained database spanning from January 2012 to January 2023 which included patients with extrapulmonary neoplasms who underwent EBUS-TBNA to diagnose mediastinal and hilar lymphadenopathy without evident pulmonary lesions on thoracic CT or PET-CT. The obtained samples were analyzed through oncotic cytology, immunohistochemistry, microbiological analysis, and immunophenotyping. The outcomes of EBUS-TBNA were evaluated against results obtained from surgical biopsies or alternative diagnostic procedures, as well as follow-ups with a minimum duration of six months. Results This study encompassed 244 patients, with an average age of 58 years, and a near-equal gender distribution. Analysis revealed no significant correlation between the size or Standard Uptake Value (SUV) of lymph nodes and their classification as malignant or benign, nor was there a distinction based on the lymph nodes being unilateral or bilateral. The diagnostic sensitivity of EBUS-TBNA for detecting malignancy was 88.5%, with a negative predictive value of 84.8% and an overall diagnostic accuracy of 93% for malignancy. Conclusion EBUS-TBNA is a safe and minimally invasive technique that exhibits high sensitivity in the diagnosis of mediastinal and hilar metastases among patients with extrapulmonary neoplasms. This abstract is funded by: None
Rivas et al. (Fri,) studied this question.