Utility of needle core specimen in improving the diagnostic yield of EBUS TBNA

Main Article Content

Sujith Varghese Abraham

Abstract

OBJECTIVES
EBUS-TBNA has become a highly sensitive, minimally invasive, outpatient procedure for the assessment of mediastinal adenopathy. The standard cytological analysis is the preferred modality for diagnosis from EBUS-TBNA and diagnostic value of needle core specimen is less studied. The current study fills the gap by comparing utility of EBUS needle-core specimen histology to EBUS FNA cytology.
METHODS
196 patients who underwent EBUS-TBNA between January 2017 and March 2020 in a single centre were included in the study. Diagnostic yields of two specimen-processing techniques, fixed slides (cytology) and needle core samples (histology) were compared.


RESULTS
The composite diagnostic index had found disease etiology in 176 of the 196 patients. EBUS cytology specimens were diagnostic in 125 cases (63.77%) and needle core specimen histology in 154 cases (78.57%). Combining both increased the yield to 166 (84.69%). Out of the total 186 in which both samples were available, the additional yield of histology samples over cytology samples was 19.351% whereas, that of cytology over histology was only 5.37%.
Evaluation of needle core specimen histology is statistically significant over smear cytology in terms of sensitivity, specificity and diagnostic accuracy (p<0.05). Also, combined evaluation of cytology and histology improved the negative predictive value of the test than both considered separate (p<0.05).
CONCLUSION
Procuring needle core specimens for histological analysis improves the overall diagnostic yield of EBUS-TBNA than cytology alone. EBUS TBNA technique has yielded tissue samples adequate enough to perform molecular profiling for targeted therapies in lung cancer and microbiological investigations related to tuberculosis.

Article Details

Section
Original Articles
Author Biography

Sujith Varghese Abraham

Department of Respiratory Medicine, Kerala Institute of
Medical Sciences , Anayara P.O, Thiruvananthapuram,
Kerala, India 695029