Search

Abstract Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been recently introduced as a new technique for sampling the hilar/ mediastinal lesions [lymph node (LN) enlargement or masses] with a potential to improve the diagnostic yield as it allows direct visualization of lesion beyond the tracheobronchial wall allowing real-time sampling. EBUS-TBNA diagnostic yield has been satisfactory for both benign and malignant lesions. Aim To evaluate the utility of convex probe EBUS-TBNA in the diagnosis of hilar and mediastinal lesions (LN enlargement or masses). Patients and methods This is a prospective study in which EBUS-guided TBNA via a real-time ultrasound bronchoscope was used to diagnose 25 patients with mediastinal or hilar LN enlargement or masses. Results EBUS-guided TBNA was performed on 15 patients with enlarged mediastinal/hilar LNs and 11 patients with mediastinal masses, achieving specific diagnosis in 73.3% (11/15) and 81.8% (9/11), respectively. The overall diagnostic yield of EBUS-TBNA was 76% (19/25). Overall sensitivity was 82.6%, specificity 100%, positive predictive value 100%, and negative predictive value 33.33%. EBUS-TBNA procedure had no complications in 76% of cases. Conclusion EBUS-TBNA is a minimally invasive, safe, yet still underutilized diagnostic technique with adequate diagnostic yield. Its nationwide application in the field of diagnostic bronchoscopy should be encouraged.

Abstract Background Screening for pulmonary arterial hypertension (PAH), a leading cause of death in systemic sclerosis, facilitates earlier treatment. The aim of this work was to study connective tissue disease (CTD)-associated PAH guided by ‘DETECT’ algorithm. Patients and methods This study was a prospective cross-sectional study conducted on 30 patients with CTDs, including 16 cases with systemic sclerosis, nine cases with systemic lupus erythromatosis, and five cases with rheumatoid arthritis. Results According to right heart catheterization finding, estimated total sensitivity and specificity of step 1 and step 2 in diagnosis of PAH among all cases were 80 and 64%, respectively. Conclusion The novel, evidence-based DETECT algorithm for PAH detection in CTDs is a sensitive, noninvasive tool and addresses resource usage.