| Autor: |
Tetart M; Service Des Maladies Infectieuses, Centre Hospitalier de Tourcoing, 135 Avenue du Président Coty, 59200, Tourcoing, France., Betraoui F; Service de Pneumologie, Centre Hospitalier de Tourcoing, Tourcoing, France., Huleux T; Service Des Maladies Infectieuses, Centre Hospitalier de Tourcoing, 135 Avenue du Président Coty, 59200, Tourcoing, France., Wallyn F; Service D'Endoscopie Bronchique, Centre Hospitalier Régional Universitaire de Lille, Lille, France., Brichet A; Service de Pneumologie, Centre Hospitalier de Roubaix, Roubaix, France., Thill P; Service Des Maladies Infectieuses, Centre Hospitalier de Tourcoing, 135 Avenue du Président Coty, 59200, Tourcoing, France., Robineau O; Service Des Maladies Infectieuses, Centre Hospitalier de Tourcoing, 135 Avenue du Président Coty, 59200, Tourcoing, France., Meybeck A; Service Des Maladies Infectieuses, Centre Hospitalier de Tourcoing, 135 Avenue du Président Coty, 59200, Tourcoing, France. agnesmeybeck@yahoo.fr. |
| Abstrakt: |
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an innovative technique to explore hilar and mediastinal lymphadenopathy. We aimed to assess its diagnostic accuracy in HIV-infected patients in a tuberculosis low-burden area. A retrospective review was performed of all HIV-infected patients with thoracic lymphadenopathy referred for EBUS-TBNA between January 2012 and January 2019 in 3 Northern French Hospitals. A total of 15 patients was included during the study period. Our patients were predominantly male (80%), with a mean age of 50 ± 11 years. Six patients (43%) had a CD4 cells count of less than 200/mm 3 . Eleven patients (73%) were receiving antiretroviral therapy, and 7 (47%) reached undetectable viral load. Adequate lymphnode sampling was accomplished in all patients. No serious complications were reported. EBUS-TBNA led to a definitive diagnosis in 12 out of 15 patients (80%). It identified 4 neoplasia, 3 atypical mycobacterial diseases, 2 tuberculosis, 1 Castleman disease, 1 sarcoidosis, and 1 professional dustiness. In 3 cases, sampling revealed normal lymphoid tissue. Active surveillance confirmed the suspected diagnosis of HIV adenitis with regression of lymphadenopathy on antiretroviral therapy in 2 cases. In one case of negative sampling, thoracoscopy led to the diagnosis of tuberculosis. In our cohort, accuracy of EBUS-TBNA was 92%. EBUS-TBNA appeared to be a safe and accurate tool in the investigation of mediastinal lymphadenopathy in HIV-infected patients in settings of tuberculosis low-prevalence. It can avoid more invasive procedures such as mediastinoscopy. |
