الفهرس 
MediastinumOnly 14 pages are availabe for public view
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Abstract
The present study aimed to evaluating the role of EBUS-TBNA in the diagnosis of hilar and mediastinal lesions on 25 patients at Abbassia Chest hospital and Kobri El-koba Military Hospital patients with suspicious CT chest findings of mediastinal or hilar lymph node enlargement or masses in /or around the tracheobronchial airway, excluding patients who are clinically unfit for respiratory endoscopy
All patients involved in the study were subjected to the following:
1. Full demographic data regarding the patient, medical history taking, thorough clinical examination, and routine laboratory investigations.
2. CT-scan of the chest with contrast.
3. Using EBUS assessment of all accessible lymph nodes was made. Under direct ultrasound guidance, the lymph node was then aspirated using 22-gauge needle, and the procedure was documented by images
4. Endobronchial ultrasound-guided transbronchial needle aspiration done under local (at kobri elkoba) and general anesthesia (at abassia) 5. Cytopathologist evaluated the specimen the aspirated cytological specimens.
6. When EBUS-TBNA did not provide specific diagnosis by cytology, patients undergo surgery, and/or clinical follow-up for 6 months.
The following results obtained:
1- Among the studied cases, the mean ± SD of age was 57.2±11.9 years ,60%(15 cases) were males and 40%(10 cases) were females
2- Dyspnea was the commonest complaint as it was present in 96% (24 of the enrolled cases) followed by chest pain in 24% (6 cases).
3- In this study LN enlargement was the most frequent encountered finding and founded in 60% of CT scan whereas mediastinal masses were found in 44% and parenchymal lesions in 16%
4- In this study EBUS-TBNA procedure had no complications in 76% of cases, bleeding occurred in 24% and it was self-limiting with no need of interference.
5- In this study the number of biopsies taken by EBUS-TBNA per patient ranged from (2-7) per patient per procedure.6- EBUS-TBNA diagnosis sensitivity 82.6%, specificity 100%, Positive Predictive value (PPV) 100%, while Negative Predictive value (NPV) 33.33%
7- EBUS-TBNA cytology finally diagnosed 76% (n=19) of the cases (malignant 40%, sarcoidosis 28%, TB 8%, suspect diagnosis in 1 case (4%).
8- Regarding malignancy EBUS-TBNA was significant in diagnosis as P value <0.050, its diagnosis was true positive in 40% and true negative in 52%, and it was near perfect agreement between EBUS-TBNA diagnosis and Final diagnosis regarding malignancy. Regarding sarcoidosis EBUS-TBNA was significant in diagnosis as P.value<0.050, its diagnosis was true positive in 28% and true negative in 64% , and it was near perfect agreement between EBUS-TBNA diagnosis and final diagnosis regarding sarcoidosis. Regarding TB; EBUS-TBNA was significant in diagnosis of malignancy as P.value<0.050, its diagnosis was true positive in 8% and true negative in 92%, and it was perfect in TB diagnosis.