Diagnosis and Subtyping of De Novo and Relapsed Mediastinal Lymphomas by Endobronchial Ultrasound Needle Aspiration

Mufaddal Moonim; Ronan Breen; Paul Fields; George Santis

doi:10.1164/rccm.201303-0462OC

Diagnosis and Subtyping of De Novo and Relapsed Mediastinal Lymphomas by Endobronchial Ultrasound Needle Aspiration

Mufaddal Moonim, Ronan Breen, Paul Fields, George Santis^*

^*Corresponding author for this work

GSTT Guy's and St Thomas' NHS Foundation Trust

Research output: Contribution to journal › Article › peer-review

86 Citations (Scopus)

Abstract

Rationale: The current management of lymphoma requires accurate diagnosis and subtyping of de novo lymphoma and of relapsed or refractory lymphoma in known cases. The role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the clinical management of lymphomas is unclear.

Objectives: To investigate the use of EBUS-TBNA in the diagnosis of de novo and relapsed mediastinal lymphomas.

Methods: A total of 2,256 consecutive patients who underwent EBUS-TBNA in a tertiary center between February 2008 and April 2013 were prospectively evaluated. The diagnostic accuracy and clinical use of EBUS-TBNA in 100 cases of de novo or suspected relapsed mediastinal lymphoma was investigated by comparing EBUS-TBNA diagnosis with the final diagnosis.

Measurements and Main Results: De novo mediastinal lymphoma was correctly diagnosed by EBUS-TBNA in 45 (88%) of 51 and relapsed lymphoma in 15 (100%) of 15 lymphoma cases. EBUS-TBNA accurately established a diagnosis other than lymphoma in 32 (97%) of 33 patients with suspected lymphoma relapse. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in the diagnosis of mediastinal lymphoma were 89%, 97%, 98%, 83%, and91%, respectively. Sensitivity of EBUS-TBNA in subtyping lymphomas into high-grade non-Hodgkin lymphoma, low-grade non-Hodgkin lymphoma, and Hodgkin lymphoma was 90%, 100%, and 79%, respectively. EBUS-TBNA diagnosis was adequate for clinical management in 84 (84%) of 100 cases.

Conclusions: Multimodality evaluation of EBUS-TBNA can be successful in the diagnosis of de novo mediastinal lymphomas and is ideally suited in distinguishing lymphoma relapse from alternative pathologies; it is least sensitive in subtyping Hodgkin lymphoma.

Original language	English
Pages (from-to)	1216-1223
Number of pages	8
Journal	American Journal of Respiratory and Critical Care Medicine
Volume	188
Issue number	10
DOIs	https://doi.org/10.1164/rccm.201303-0462OC
Publication status	Published - 15 Nov 2013

Keywords

lymphoma
fine-needle aspiration
cytology
endobronchial ultrasound
B-CELL LYMPHOMA
NON-HODGKIN-LYMPHOMA
FLOW-CYTOMETRY
LUNG-CANCER
LYMPHOPROLIFERATIVE DISORDERS
LYMPHADENOPATHY
CLASSIFICATION
BIOPSY
TRIAL
SUBCLASSIFICATION

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1164/rccm.201303-0462OC

Cite this

@article{e46c180bf6a143e2af1768a18920f485,

title = "Diagnosis and Subtyping of De Novo and Relapsed Mediastinal Lymphomas by Endobronchial Ultrasound Needle Aspiration",

abstract = "Rationale: The current management of lymphoma requires accurate diagnosis and subtyping of de novo lymphoma and of relapsed or refractory lymphoma in known cases. The role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the clinical management of lymphomas is unclear.Objectives: To investigate the use of EBUS-TBNA in the diagnosis of de novo and relapsed mediastinal lymphomas.Methods: A total of 2,256 consecutive patients who underwent EBUS-TBNA in a tertiary center between February 2008 and April 2013 were prospectively evaluated. The diagnostic accuracy and clinical use of EBUS-TBNA in 100 cases of de novo or suspected relapsed mediastinal lymphoma was investigated by comparing EBUS-TBNA diagnosis with the final diagnosis.Measurements and Main Results: De novo mediastinal lymphoma was correctly diagnosed by EBUS-TBNA in 45 (88%) of 51 and relapsed lymphoma in 15 (100%) of 15 lymphoma cases. EBUS-TBNA accurately established a diagnosis other than lymphoma in 32 (97%) of 33 patients with suspected lymphoma relapse. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in the diagnosis of mediastinal lymphoma were 89%, 97%, 98%, 83%, and91%, respectively. Sensitivity of EBUS-TBNA in subtyping lymphomas into high-grade non-Hodgkin lymphoma, low-grade non-Hodgkin lymphoma, and Hodgkin lymphoma was 90%, 100%, and 79%, respectively. EBUS-TBNA diagnosis was adequate for clinical management in 84 (84%) of 100 cases.Conclusions: Multimodality evaluation of EBUS-TBNA can be successful in the diagnosis of de novo mediastinal lymphomas and is ideally suited in distinguishing lymphoma relapse from alternative pathologies; it is least sensitive in subtyping Hodgkin lymphoma.",

keywords = "lymphoma, fine-needle aspiration, cytology, endobronchial ultrasound, B-CELL LYMPHOMA, NON-HODGKIN-LYMPHOMA, FLOW-CYTOMETRY, LUNG-CANCER, LYMPHOPROLIFERATIVE DISORDERS, LYMPHADENOPATHY, CLASSIFICATION, BIOPSY, TRIAL, SUBCLASSIFICATION",

author = "Mufaddal Moonim and Ronan Breen and Paul Fields and George Santis",

year = "2013",

month = nov,

day = "15",

doi = "10.1164/rccm.201303-0462OC",

language = "English",

volume = "188",

pages = "1216--1223",

journal = "American Journal of Respiratory and Critical Care Medicine",

issn = "1073-449X",

publisher = "American Thoracic Society",

number = "10",

}

TY - JOUR

T1 - Diagnosis and Subtyping of De Novo and Relapsed Mediastinal Lymphomas by Endobronchial Ultrasound Needle Aspiration

AU - Moonim, Mufaddal

AU - Breen, Ronan

AU - Fields, Paul

AU - Santis, George

PY - 2013/11/15

Y1 - 2013/11/15

N2 - Rationale: The current management of lymphoma requires accurate diagnosis and subtyping of de novo lymphoma and of relapsed or refractory lymphoma in known cases. The role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the clinical management of lymphomas is unclear.Objectives: To investigate the use of EBUS-TBNA in the diagnosis of de novo and relapsed mediastinal lymphomas.Methods: A total of 2,256 consecutive patients who underwent EBUS-TBNA in a tertiary center between February 2008 and April 2013 were prospectively evaluated. The diagnostic accuracy and clinical use of EBUS-TBNA in 100 cases of de novo or suspected relapsed mediastinal lymphoma was investigated by comparing EBUS-TBNA diagnosis with the final diagnosis.Measurements and Main Results: De novo mediastinal lymphoma was correctly diagnosed by EBUS-TBNA in 45 (88%) of 51 and relapsed lymphoma in 15 (100%) of 15 lymphoma cases. EBUS-TBNA accurately established a diagnosis other than lymphoma in 32 (97%) of 33 patients with suspected lymphoma relapse. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in the diagnosis of mediastinal lymphoma were 89%, 97%, 98%, 83%, and91%, respectively. Sensitivity of EBUS-TBNA in subtyping lymphomas into high-grade non-Hodgkin lymphoma, low-grade non-Hodgkin lymphoma, and Hodgkin lymphoma was 90%, 100%, and 79%, respectively. EBUS-TBNA diagnosis was adequate for clinical management in 84 (84%) of 100 cases.Conclusions: Multimodality evaluation of EBUS-TBNA can be successful in the diagnosis of de novo mediastinal lymphomas and is ideally suited in distinguishing lymphoma relapse from alternative pathologies; it is least sensitive in subtyping Hodgkin lymphoma.

AB - Rationale: The current management of lymphoma requires accurate diagnosis and subtyping of de novo lymphoma and of relapsed or refractory lymphoma in known cases. The role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the clinical management of lymphomas is unclear.Objectives: To investigate the use of EBUS-TBNA in the diagnosis of de novo and relapsed mediastinal lymphomas.Methods: A total of 2,256 consecutive patients who underwent EBUS-TBNA in a tertiary center between February 2008 and April 2013 were prospectively evaluated. The diagnostic accuracy and clinical use of EBUS-TBNA in 100 cases of de novo or suspected relapsed mediastinal lymphoma was investigated by comparing EBUS-TBNA diagnosis with the final diagnosis.Measurements and Main Results: De novo mediastinal lymphoma was correctly diagnosed by EBUS-TBNA in 45 (88%) of 51 and relapsed lymphoma in 15 (100%) of 15 lymphoma cases. EBUS-TBNA accurately established a diagnosis other than lymphoma in 32 (97%) of 33 patients with suspected lymphoma relapse. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in the diagnosis of mediastinal lymphoma were 89%, 97%, 98%, 83%, and91%, respectively. Sensitivity of EBUS-TBNA in subtyping lymphomas into high-grade non-Hodgkin lymphoma, low-grade non-Hodgkin lymphoma, and Hodgkin lymphoma was 90%, 100%, and 79%, respectively. EBUS-TBNA diagnosis was adequate for clinical management in 84 (84%) of 100 cases.Conclusions: Multimodality evaluation of EBUS-TBNA can be successful in the diagnosis of de novo mediastinal lymphomas and is ideally suited in distinguishing lymphoma relapse from alternative pathologies; it is least sensitive in subtyping Hodgkin lymphoma.

KW - lymphoma

KW - fine-needle aspiration

KW - cytology

KW - endobronchial ultrasound

KW - B-CELL LYMPHOMA

KW - NON-HODGKIN-LYMPHOMA

KW - FLOW-CYTOMETRY

KW - LUNG-CANCER

KW - LYMPHOPROLIFERATIVE DISORDERS

KW - LYMPHADENOPATHY

KW - CLASSIFICATION

KW - BIOPSY

KW - TRIAL

KW - SUBCLASSIFICATION

U2 - 10.1164/rccm.201303-0462OC

DO - 10.1164/rccm.201303-0462OC

M3 - Article

SN - 1073-449X

VL - 188

SP - 1216

EP - 1223

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

IS - 10

ER -

Diagnosis and Subtyping of De Novo and Relapsed Mediastinal Lymphomas by Endobronchial Ultrasound Needle Aspiration

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this