Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and efficacious diagnostic modality for lung cancer staging and evaluation of undiagnosed mediastinal lymphadenopathy. Procedure-related complications are uncommon. We herein report an infrequently described phenomenon following EBUS-TBNA in which two patients developed nodular granulation tissue at the tracheobronchial puncture site. On systematic review, we found description of such phenomena by terminologies such as endobronchial inflammatory polyp, granuloma, and endobronchial mass. The endobronchial inflammatory polyp has been one of the most commonly used terminologies for these; but in most cases, the classical features of an inflammatory polyp are lacking. We propose the term, tracheobronchial puncture-site nodular reaction (TPNR) with further classification into granulomatous and nongranulomatous subtypes, for standardized reporting of such reactions following transbronchial needle aspiration procedures. Knowledge of this entity and standardized nomenclature shall help in better characterization of the outcomes and risk factors for the occurrence of these reactions.
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http://dx.doi.org/10.4103/lungindia.lungindia_12_17 | DOI Listing |
Diagn Cytopathol
January 2025
Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri, USA.
Background: Endobronchial ultrasound guided Transbronchial Needle Aspiration (EBUS-TBNA) is the predominant method for investigation of centrally located solitary pulmonary nodules. The method is associated with good to excellent diagnostic sensitivity and specificity with the positive predictive value of the test reaching 100% and reported negative predictive values for FNA of pulmonary nodules ranging from 53% to 97%. The impact of correlating cytologic results with imaging and clinical findings for improvement of negative predictive value has been poorly studied.
View Article and Find Full Text PDFRespir Med Case Rep
November 2024
Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
Med J Armed Forces India
December 2024
Assistant Professor (Pulmonary Medicine), Command Hospital (Western Command), Chandigarh, India.
Background: The evaluation of mediastinal lymphadenopathy and masses poses a diagnostic challenge because of a myriad of possible etiologic causes; their proximity to numerous vital structures and the difficulty of access for biopsy. Computed tomography is an excellent modality for the initial evaluation of mediastinal lymph nodes (LNs). Tissue diagnosis is of paramount importance to confirm the diagnosis of mediastinal lymphadenopathy.
View Article and Find Full Text PDFCureus
November 2024
Department of Pathology, Okayama University Hospital, Okayama, JPN.
A 71-year-old man with follicular lymphoma of the right inguinal lymph node was referred to our hospital owing to mediastinal lymph node enlargement (left #12). The patient had a history of cyclosporine (CYS-A) and steroid therapy for fibrotic hypersensitivity pneumonitis. Endobronchial ultrasound-transbronchial aspiration and endobronchial ultrasound-guided intranodal forceps biopsy (EBUS-IFB) were performed under conscious sedation using midazolam and fentanyl.
View Article and Find Full Text PDFJTCVS Tech
December 2024
Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Objective: Endobronchial ultrasound-guided transbronchial needle aspiration is a vital tool for mediastinal and hilar lymph node staging in patients with lung cancer. Despite its high diagnostic performance and safety, it has a limited negative predictive value. Our objective was to evaluate the diagnostic performance of deep learning-based prediction of lung cancer lymph node metastases using convolutional neural networks developed from automatically extracted images of endobronchial ultrasound videos without supervision of the lymph node location.
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