• Pediatric pulmonology · Oct 2016

    Multicenter Study

    A multicenter study on the utility and safety of EBUS-TBNA and EUS-B-FNA in children.

    • Sahajal Dhooria, Karan Madan, Vallandramam Pattabhiraman, Inderpaul Singh Sehgal, Ravindra Mehta, Gella Vishwanath, Arjun Srinivasan, Mahadevan Sivaramakrishnan, Anant Mohan, Joseph L Mathew, Sushil K Kabra, Randeep Guleria, Digambar Behera, and Ritesh Agarwal.
    • Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
    • Pediatr. Pulmonol. 2016 Oct 1; 51 (10): 1031-1039.

    Background And AimEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound with an echobronchoscope-guided fine needle aspiration (EUS-B-FNA) are useful modalities in the evaluation of mediastinal lymphadenopathy in adults; however, there is sparse data in children. The aim of this multicenter study is to describe the efficacy and safety of EBUS-TBNA and EUS-B-FNA in children with mediastinal lymphadenopathy of undefined etiology.MethodsRetrospective analysis of consecutive pediatric (<18 years) subjects who underwent EBUS-TBNA or EUS-B-FNA for the evaluation of mediastinal lymphadenopathy. The demographic characteristics, indications, procedural details, pathological, cytological and microbiological diagnosis, diagnostic yield, and complications are presented.ResultsOf the 3,424 EBUS/EUS-B-FNA procedures, 67 (1.9%) were performed in the pediatric (3-17 years) population. Of these, 19 (28.4%) were performed in children ≤12 years of age. Overall, EBUS-TBNA and EUS-B-FNA were performed in 53 and 12 subjects, respectively. In two subjects, no significant lymph node was seen on EBUS. The procedure was performed under moderate sedation in spontaneously breathing subjects in 54 (80.6%) instances. An adequate sample was obtained in 60 (92.3%) subjects while a diagnostic sample was obtained in 37 (56.9%) of the 65 subjects. The diagnostic yield was not significantly different (P = 0.59) between EBUS-TBNA (58.5%) and EUS-B-FNA (50%). The sensitivity of EBUS-TBNA/EUS-B-FNA was 79.1% and led to a change in diagnosis in 28 (41.8%) subjects. Complications, all minor were encountered in six (8.9%) subjects.ConclusionsEBUS-TBNA and EUS-B-FNA are safe techniques with a good diagnostic yield in the evaluation of children with mediastinal lymphadenopathy. Pediatr Pulmonol. 2016;51:1031-1039. © 2016 Wiley Periodicals, Inc.© 2016 Wiley Periodicals, Inc.

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