Background Silicosis is an occupational lung disease resulting from inhalation of respirable crystalline silica. Recently, an international silicosis epidemic has been noted among artificial stone workers. Objective Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is currently used for patients with unexplained lymphadenopathy. Since silicosis may present with prominent lymphadenopathy, the diagnostic yield of EBUS-TBNA in diagnosing silicosis was evaluated. Methods Twenty-eight patients with suspected silicosis referred for outpatient evaluation in three large tertiary hospitals were evaluated. Patients with mediastinal lymphadenopathy underwent EBUS-TBNA, while others underwent TBB and/or video-assisted thoracoscopic surgery (VATS). Results Eleven patients with mediastinal lymphadenopathy (39%) were evaluated using EBUS-TBNA. The diagnosis was accurate in all cases, demonstrating silica particles under polarized light, with no complications. Among the remaining patients, TBB was only 76% diagnostic, therefore requiring VATS. Conclusions EBUS-TBNA is a useful and sufficient tool to diagnose silicosis in patients with mediastinal lymphadenopathy along compatible exposure histories. Keywords Bronchoscopy · Diagnostic and therapeutic bronchology · Endobronchial ultrasound · Occupational lung disease Abbreviations PMF Progressive massive fibrosis EBUS-TBNA Endobr onchial ultrasound-guided trans- VATS Video-assisted thoracoscopic surgery bronchial needle aspiration FB Fiberoptic bronchoscopy HRCT High-resolution computed tomography Introduction TBB Transbronchial biopsy Silicosis is a progressive, fibrotic, occupational lung dis- ease resulting from
Lung – Springer Journals
Published: May 29, 2018
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