EBUS-TBNA and CryoEBUS of the mediastinal lymph node. One hundred seventy-eight cases. Validation of the WHO Reporting System for Lymph Node Cytopathology. Proposed CryoEBUS diagnostic flow chart and indications. The view of the interventional pathologist

Abstract

Introduction

Microscopic assessment is essential in the study of mediastinal lymph nodes. Obtaining cytological samples through Endobronchial Ultrasound TransBronchial Needle Aspiration (EBUS-TBNA) has long been considered the gold standard procedure. The implementation of the World Health Organization (WHO) Reporting System for Lymph Node Cytopathology, along with the advancement of the CryoEBUS lymph node technique, has enhanced and refined diagnostic accuracy in this field.

Materials and method

During a two-year period, cases involving the parallel performance of EBUS-TBNA and CryoEBUS specimen collection were quantified. The implementation of the WHO Reporting System allowed for the comparison of diagnostic yield between cytological and CryoEBUS tissue samples.

Results

A total of 178 EBUS-TBNA and CryoEBUS procedures were conducted, with a mean patient age of 63 years and a male predominance of 72.5%. Lymph node station 7 was the most sampled site, accounting for 38.76% of cases. Category V – malignant was the most common cytological diagnosis, representing 50% of cases, while 46.62% of CryoEBUS samples were malignant. The Pearson correlation coefficient between the two methods was calculated at 0.99.

Conclusions

The combined implementation of the WHO Reporting System for Lymph Node Cytopathology and the simultaneous use of CryoEBUS resulted in enhanced performance and diagnostic accuracy, reducing non-diagnostic samples to less than 3%.