Citation Information :
Rai DK, Singh NK, Vinay V. A Case of Mediastinal Lymphoma that was Missed on EBUS-TBNA but Correctly Diagnosed after EBUS-TBCNB. Indian J Chest Dis Allied Sci 2024; 66 (3):102-105.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a breakthrough in diagnosing mediastinal diseases. However, it is less sensitive in diagnosing some mediastinal diseases, where diagnosis largely depends on a larger tissue sample with preserved tissue architecture, such as lymphoproliferative diseases of the mediastinum. Another newer approach, endobronchial ultrasound-guided transbronchial mediastinal cryonodal biopsy (EBUS-TBCNB), can overcome the limitations of EBUS-TBNA and provide larger samples with preserved tissue architecture. Here we present a case of an elderly female with multiple mediastinal lymphadenopathy who underwent EBUS-TBNA two times, despite adequate sampling, the diagnosis remains inconclusive. We were only able to make a diagnosis of mediastinal lymphoma after EBUS-TBCNB under conscious sedation. Endobronchial ultrasound-guided transbronchial mediastinal cryonodal biopsy is a safe and effective procedure that can be used in the successful diagnosis of mediastinal pathologies where EBUS-TBNA remained inconclusive, or it may be used as a combined procedure with EBUS-TBNA in cases of diagnostic uncertainty.
Eknewir S, John TJ, Bennji SM, et al. The utility of endobronchial ultrasound-guided transbronchial needle aspiration in a community with a high HIV and tuberculosis burden. Afr J Thorac Crit Care Med 2022;28(1):25–27. DOI: 10.7196/AJTCCM.2022.v28i1.156.
Chandra S, Nehra M, Agarwal D, et al. Diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle biopsy in mediastinal lymphadenopathy: A systematic review and meta-analysis. Respir Care 2012;57(3):384–391. DOI: 10.4187/respcare.01274.
Erer OF, Erol S, Anar C, et al. Diagnostic yield of EBUS-TBNA for lymphoma and review of the literature. Endosc Ultrasound 2017;6(5):317–322. DOI: 10.4103/2303-9027.180762.
Poletti V, Petrarulo S, Piciucchi S, et al. EBUS-guided cryobiopsy in the diagnosis of thoracic disorders. Pulmonology 2024;30(5):459–465. DOI: 10.1016/j.pulmoe.2023.11.008.
Salcedo Lobera E, Codeso FMP, Casado Miranda E. Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy: Series of 50 cases. Rev Clin Esp (Barc) 2023;223(9):578–581. DOI: 10.1016/j.rceng.2023.09.002.
Ramarmuty HY, Oki M. Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy: A narrative review. Mediastinum 2023;8:2. DOI: 10.21037/med-23-34.
Zhang J, Guo JR, Huang ZS, et al. Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: A randomised trial. Eur Respir J 2021;58(6):2100055. DOI: 10.1183/13993003.00055-2021.
Fan Y, Zhang AM, Wu XL, et al. Transbronchial needle aspiration combined with cryobiopsy in the diagnosis of mediastinal diseases: A multicentre, open-label, randomised trial. Lancet Respir Med 2023;11(3):256–264. DOI: 10.1016/S2213-2600(22)00392-7.
von Bartheld MB, van Breda A, Annema JT. Complication rate of endosonography (endobronchial and endoscopic ultrasound): A systematic review. Respiration 2014;87(4):343–351. DOI: 10.1159/000357066.
Gonuguntla HK, Shah M, Gupta N, et al. Endobronchial ultrasound-guided transbronchial cryo-nodal biopsy: A novel approach for mediastinal lymph node sampling. Respirol Case Rep 2021;9(8):e00808. DOI: 10.1002/rcr2.808.
Ramarmuty HY, Huan NC, Nyanti LE, et al. Early experience of endobronchial ultrasound-guided transbronchial nodal cryobiopsy: A case series from Sabah, Malaysia. Ther Adv Respir Dis 2024;18:17534666241231122. DOI: 10.1177/17534666241231122.
