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Diagnostic Yield of Endobronchial Ultrasound in the Diagnosis of Lymphoproliferative Syndromes
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A7298 - Diagnostic Yield of Endobronchial Ultrasound in the Diagnosis of Lymphoproliferative Syndromes
Author Block: M. Lopez1, R. Cordovilla2, J. Cascon2, M. Rodriguez2, V. Guevara2, S. Jodra2, J. González2, M. Barrueco2; 1Hospital 12 de Octubre, Madrid, Spain, 2Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Introduction: The usefulness of endobronchial ultrasound (EBUS) in the diagnosis of lymphoproliferative syndromes (LPS) is still subject to debate, despite the positive data published in the literature. The objective of our study was to assess the diagnostic yield of EBUS in our Unit, as well as the factors that affect it. Methods: A retrospective analysis was performed on a prospective database with a series of 33 patients with a final diagnosis of LPS who underwent EBUS as a first diagnostic test. The samples collected after the punctures were sent to the anatomic pathology and flow cytometry units. The samples collected after the punctures were sent to Pathological Anatomy and Flow Cytometry departments. Rapid on-site examination was present. The following variables were analyzed: sex, indication (de novo or recurrent), diagnosis of the EBUS (anatomic pathology and/or cytometry), method of confirmation and type of lymphoma. In the statistical analysis, the statistical software package SPSS 20 was used. Results: Out of the 33 patients diagnosed with lymphoproliferative syndrome (LPS), there were 23 non-Hodgkin lymphomas (70%) and 10 Hodgkin lymphomas (30%). The most common indication was a de novo diagnosis, and recurrence was suspected in only 4 patients (12%). The EBUS diagnosed correctly 23 patients (70%), with 6 false negatives (18%) and 4 were non-diagnostic (12%). Out of the 23 LPS cases diagnosed with EBUS, 7 were identified with pathological anatomy (21%), 3 with cytometry (9%), and 13 with both techniques (39%). The confirmation method was mediastinoscopy in 10 cases (30.3%), extrathoracic biopsy in 7 cases (21.2%) and bone marrow biopsy in 1 case (3%). There were 15 cases in which no further tests were required (45.5%). The global sensitivity of the test was 79%, with no differences between de novo diagnoses and diagnoses of recurrence. The diagnostic yield in the Hodgkin group was 67%, and in the non-Hodgkin group it was 85%. Conclusions: The diagnostic yield of EBUS in the diagnosis of non-Hodgkin lymphoma in our series is high. Therefore, this test should be performed as a first diagnostic choice in cases in which LPS is suspected.
Author Block: M. Lopez1, R. Cordovilla2, J. Cascon2, M. Rodriguez2, V. Guevara2, S. Jodra2, J. González2, M. Barrueco2; 1Hospital 12 de Octubre, Madrid, Spain, 2Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Introduction: The usefulness of endobronchial ultrasound (EBUS) in the diagnosis of lymphoproliferative syndromes (LPS) is still subject to debate, despite the positive data published in the literature. The objective of our study was to assess the diagnostic yield of EBUS in our Unit, as well as the factors that affect it. Methods: A retrospective analysis was performed on a prospective database with a series of 33 patients with a final diagnosis of LPS who underwent EBUS as a first diagnostic test. The samples collected after the punctures were sent to the anatomic pathology and flow cytometry units. The samples collected after the punctures were sent to Pathological Anatomy and Flow Cytometry departments. Rapid on-site examination was present. The following variables were analyzed: sex, indication (de novo or recurrent), diagnosis of the EBUS (anatomic pathology and/or cytometry), method of confirmation and type of lymphoma. In the statistical analysis, the statistical software package SPSS 20 was used. Results: Out of the 33 patients diagnosed with lymphoproliferative syndrome (LPS), there were 23 non-Hodgkin lymphomas (70%) and 10 Hodgkin lymphomas (30%). The most common indication was a de novo diagnosis, and recurrence was suspected in only 4 patients (12%). The EBUS diagnosed correctly 23 patients (70%), with 6 false negatives (18%) and 4 were non-diagnostic (12%). Out of the 23 LPS cases diagnosed with EBUS, 7 were identified with pathological anatomy (21%), 3 with cytometry (9%), and 13 with both techniques (39%). The confirmation method was mediastinoscopy in 10 cases (30.3%), extrathoracic biopsy in 7 cases (21.2%) and bone marrow biopsy in 1 case (3%). There were 15 cases in which no further tests were required (45.5%). The global sensitivity of the test was 79%, with no differences between de novo diagnoses and diagnoses of recurrence. The diagnostic yield in the Hodgkin group was 67%, and in the non-Hodgkin group it was 85%. Conclusions: The diagnostic yield of EBUS in the diagnosis of non-Hodgkin lymphoma in our series is high. Therefore, this test should be performed as a first diagnostic choice in cases in which LPS is suspected.
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