Usefulness of Endobronchial Ultrasound in Patients with Human Immunodeficiency Virus Infection and Mediastinal Lymphadenopathy

Autor: Gustavo Reyes-Terán, Rosa María Rivera-Rosales, Esmeralda Aspuru-García, Sebastian Fernandez-Bussy, José Arturo Martínez-Orozco, Dina Martínez-Mendoza, César Luna-Rivero, Olivia Sánchez-Cabral
Rok vydání: 2017
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
Pathology
medicine.medical_specialty
Lung Neoplasms
Mediastinal lymphadenopathy
Human immunodeficiency virus (HIV)
Lymphadenopathy
HIV Infections
Adenocarcinoma
Tuberculosis
Lymph Node
Infections
medicine.disease_cause
Bronchoalveolar Lavage
Sensitivity and Specificity
Endosonography
Young Adult
03 medical and health sciences
0302 clinical medicine
Bronchoscopy
Mediastinal Diseases
Humans
Medicine
In patient
Endobronchial ultrasound
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Sarcoma
Kaposi
Aged
Retrospective Studies
business.industry
Mediastinum
Bacterial Infections
Middle Aged
medicine.disease
Cross-Sectional Studies
Mycoses
030228 respiratory system
Virus Diseases
030220 oncology & carcinogenesis
Female
Lymphoma
Large B-Cell
Diffuse
Radiology
business
Zdroj: Respiration. 93:424-429
ISSN: 1423-0356
0025-7931
DOI: 10.1159/000465527
Popis: Background: There are few published studies about the usefulness of endobronchial ultrasound (EBUS) in patients infected with human immunodeficiency virus (HIV). The clinical spectrum of likely diseases in this population is varied and differs from patients not infected with HIV. Objective: The aim of this study was to measure the usefulness of EBUS-guided transbronchial needle aspiration (EBUS-TBNA) in HIV-infected patients with mediastinal lymphadenopathy. Materials and Methods: We conducted an observational, cross-sectional, retrospective, descriptive study on patients with HIV infection and mediastinal lymphadenopathy who underwent EBUS-TBNA between September 2014 and April 2016. The patients' final diagnosis, regardless of the sample from which it was obtained, was considered the positive gold standard, and the absence of diagnosis was the negative. The study measured diagnostic accuracy of bronchoalveolar lavage (BAL), transbronchial biopsy (TBB), and EBUS-TBNA. Results: A total of 43 procedures were performed; 79.1% (34/43) of the patients were male, and the median age was 35 years (range, 22-66). The overall diagnostic yield including all types of samples was 90.7% (39/43); the yield of BAL was 50% (21), that of TBB 61.9% (26), and that of EBUS-TBNA was 60.5% (26). The combined yield of BAL with TBB was 69.8% (30); the yield of BAL with EBUS-TBNA was 86% (37) and that of TBB with EBUS-TBNA was 88.4% (38). The highest diagnostic accuracy was 97.7% for the combination of TBB and EBUS-TBNA. Conclusions: The most common infectious diagnoses were tuberculosis, with a higher diagnostic accuracy using EBUS-TBNA than BAL. With malignancies, both EBUS-TBNA and TBB were useful. EBUS-TBNA is a minimally invasive diagnostic tool that should be considered in these patients.
Databáze: OpenAIRE
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