The effect of 19-gauge endobronchial ultrasound-guided transbronchial needle aspiration biopsies on characterisation of malignant and benign disease. The Bristol experience

Submitted: February 21, 2018
Accepted: June 3, 2018
Published: June 22, 2018
Abstract Views: 2593
PDF: 518
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Authors

EBUS-TBNA is a recent mediastinal staging and diagnostic technique. We have previously reported superior characterisation with 21G biopsies over 22G biopsies for benign and malignant mediastinal nodes. A new 19G needle now exists but there are limited studies. We hypothesised 19G biopsies would improve both benign and malignant characterisation due to larger samples. We retrospectively analysed sequential patients referred for EBUS-TBNA with unexplained mediastinal adenopathy performed with 19G, 21G and 22G needles respectively (100 patients each). Contingency table analysis was performed.  There were no complications. Sensitivity for malignancy was highest in the 19G group (95.7% versus 94.7% and 87.5%, respectively). The 19G group had higher mean lymph node size (19.4mm versus 18.6mm and 13.5mm, respectively), the highest proportion of lymphoma (9% versus 5% and 0%, respectively), the lowest proportion of NSCLC-NOS (2% versus 12% and 5%, respectively), the highest proportion of subcharacterised benign disease (89.6% versus 69.8% and 37.9%, respectively). This large single centre retrospective UK study suggests the 19G needle appears safe with the suggestion of better sensitivity for malignancy subcharacterisation of benign disease but this requires further study in adequately powered comparative controlled studies with univariate and multivariate analysis.

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Supporting Agencies

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Rachel C. Jones, North Bristol NHS Trust, North Bristol Lung Centre, Southmead Hospital
Specialist Registrar in Respiratory Medicine
Nidhi Bhatt, North Bristol NHS Trust, Southmead Hospital, Department of Cellular Pathology
Consultant Pathologist
Andrew R.L. Medford, North Bristol NHS Trust, North Bristol Lung Centre, Southmead Hospital
Consultant & Honorary Senior Lecturer in Respiratory Medicine

How to Cite

Jones, Rachel C., Nidhi Bhatt, and Andrew R.L. Medford. 2018. “The Effect of 19-Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Biopsies on Characterisation of Malignant and Benign Disease. The Bristol Experience”. Monaldi Archives for Chest Disease 88 (2). https://doi.org/10.4081/monaldi.2018.915.