BACKGROUND: Endobronchial Ultrasound with Transbronchial Needle Aspiration (EBUS-TBNA) is a well-established tool in evaluating the diverse etiologies of mediastinal lymphadenopathy. The objectives of our study included the estimation of overall, diagnostic yield in different primary tumors, and identification of the factors influencing yield. METHODS: This is a 3-year retrospective analytical study on patients with mediastinal lymph nodes who underwent EBUS-TBNA from January 2022 to December 2024 at Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman. The study included only patients with complete pathological and medical records. RESULTS: Out of the 113 EBUS-TBNA done during the study period, 111 patients were included. The mean age was 60.32 ± 14.69 years. One hundred and sixty-nine nodes were sampled with 861 sampling passes for diagnostic, staging, and molecular in 71.2%, 25.2%, and 3.6%, respectively. A single station was sampled in 67.6%, with station 7 the most common (64.9%). The overall diagnostic yield was 85.6%. Yield varied significantly by primary site ( P < 0.001); 100% in gastrointestinal, 88.6% in lung, and 81.3% in breast cancers, with malignancy diagnosed in 2 (22.2%), 29 (65.9%), and 9 (56.3%), respectively. The cytological diagnosis was reactive lymphadenopathy (27.0%), nonsmall cell lung carcinoma (21.6%), carcinoma not otherwise specified (13.5%), and granulomatous inflammation (13.5%). All type 3 nodes (11; 50%) were malignant, and all type 1 node (5; 22.7%) were benign in the 22 elastographies on patients with lung cancer ( P < 0.001). No major complications were encountered. CONCLUSIONS: EBUS-TBNA has a high diagnostic yield in mediastinal lymphadenopathy. It should be considered as the primary invasive tool for both diagnostic and staging assessment of mediastinal nodes. However, its limitations are noticeable in suspected lymphoma and molecular analysis, noting that this conclusion is limited by the small sample size.
Bennji et al. (Wed,) studied this question.