EBUS-TBNA is Sufficient for Successful Diagnosis of Silicosis with Mediastinal Lymphadenopathy

EBUS-TBNA is Sufficient for Successful Diagnosis of Silicosis with Mediastinal Lymphadenopathy 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 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Lung Springer Journals

EBUS-TBNA is Sufficient for Successful Diagnosis of Silicosis with Mediastinal Lymphadenopathy

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Pneumology/Respiratory System
ISSN
0341-2040
eISSN
1432-1750
D.O.I.
10.1007/s00408-018-0129-3
Publisher site
See Article on Publisher Site

Abstract

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

Journal

LungSpringer Journals

Published: May 29, 2018

References

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