Diagnostic Use of Endobronchial Ultrasound (EBUS) Guided Transbronchial Needle Aspiration (TBNA) in Intrathoracic Tuberculosis

INTRODUCTION: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is widely used for sampling mediastinal and intraparenchymal lymph nodes. This study aims to determine the diagnostic sensitivity of EBUS-TBNA in tuberculosis (TB) diagnosis and to establish the optimal number of punctures required for accurate sampling.
METHODS: Patients who underwent EBUS-TBNA as the initial diagnostic procedure between August 2020 and October 2023 in the pulmonology clinic were retrospectively evaluated. The study included patients with pathological findings of granulomatous lymphadenitis and a confirmed TB diagnosis. Biopsy materials were analyzed for acid-fast bacilli (AFB), mycobacterial culture, PCR results, and pathology reports.
RESULTS: Among 595 patients who underwent EBUS-TBNA as their initial diagnostic procedure, 101 (16.9%) were diagnosed with TB. Of these, 72 patients (71.28%) were diagnosed directly via EBUS-TBNA, whereas additional bronchoscopic procedures were required for 29 patients (28.72%). The mean size of the sampled lymph nodes was 1.9±0.4 cm, with an average of 5.46 aspirations performed per lymph node. The prevalence of TB among patients who underwent EBUS-TBNA was 16.9%, and the sensitivity of EBUS-TBNA in diagnosing TB was 71.28%.
DISCUSSION AND CONCLUSION: EBUS-TBNA is a safe and effective method for diagnosing intrathoracic tuberculous lymphadenitis. An average of five punctures per lymph node provided an optimal sample size for microbiological evaluation, thereby enhancing diagnostic performance.