Utility of Rapid On-Site Evaluation on Endobronchial Ultrasound-Guided Transbronchial Needle Aspirate of the Mediastinal and Hilar Lymph Nodes in Patients with Suspected Sarcoidosis

Authors

  • Vikas Pathak Attending Physician, Virginia Institute of Lung Diseases, Richmond, Virginia, USA https://orcid.org/0000-0002-7482-5908
  • Mark Richman Associate Professor of Emergency Medicine, Donald and Barbara Zucker School of Medicine, Hofstra University, New York
  • Prekchha Jha Resident Physician, Internal Medicine, Corewell Health William Beaumont University Hospital, Michigan, USA

Keywords:

Rapid On-Site Cytology, ROSE, sarcoidosis, EBUS-TBNA

Abstract

Background Rapid on-site evaluation (ROSE) is a technique where transbronchial needle aspiration (TBNA) cytology samples are rapidly stained and screened for diagnostic material in the procedure room, during the procedure. We hypothesized the sensitivity of ROSE in patients with sarcoidosis is very low, leading to unjustified use of an expensive technique.

Data and Methods This was a retrospective study at an inner-city hospital. Medical records of all patients who underwent EBUS-TBNA of mediastinal and hilar lymph nodes with ROSE over a 3-year period were evaluated. The sensitivity, specificity, and positive and negative predictive values of ROSE in patients with sarcoidosis were calculated, with pathologic diagnosis by cell block as the “gold standard.” Patients with malignancy were used as a comparison.

Results One hundred eighty-four patients who had ROSE on EBUS-TBNA of mediastinal and hilar lymph nodes were included. Thirty were diagnosed with sarcoidosis, 95 with malignancy, and 59 with benign lymph nodes. The sensitivity of ROSE in patients with sarcoidosis was 44%, specificity and positive predictive value were 100%, and negative predictive value was only 17%.

Conclusion Given low sensitivity and negative predictive value, ROSE may not be as useful in diagnosing sarcoidosis as it is in diagnosing malignancy.

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Published

2023-12-30

How to Cite

Pathak, V., Richman, M., & Jha, P. (2023). Utility of Rapid On-Site Evaluation on Endobronchial Ultrasound-Guided Transbronchial Needle Aspirate of the Mediastinal and Hilar Lymph Nodes in Patients with Suspected Sarcoidosis. Europasian Journal of Medical Sciences, 5(8). Retrieved from https://nepjol.info/index.php/ejms/article/view/63501

Issue

Vol. 5 (2023): Europasian Journal of Medical Sciences (EJMS) | Continuous Issue 8

Section

Original Articles

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Copyright (c) 2023 Vikas Pathak, Mark Richman, Prekchha Jha

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