Is it useful to analyse all waste material obtained during endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA)? (2019)

Type of publication:
Poster presentation

Author(s):
*V. Tharmarajah, *H. Hope, *E. Cobby, J. *Stafford, *R. Heinink

Citation:
European Respiratory Journal 2019 Vol. 54, Suppl 63, PA3064

Abstract:
Background: It is not standard practice to always analyse waste material obtained from EBUS in addition to the samples taken from the EBUS-TBNA needle.
Method: A retrospective review of EBUS carried out between 1/1/17 and 16/3/18 was performed. We collected data where samples were taken both via the EBUS-TBNA needle and from waste material from the same node. It was also noted as to which sample contained the most diagnostic material.
Results: 54 EBUSs were performed within the study period. If the waste obtained from both the flushing of the EBUS-TBNA needle and from the flushing of the suction syringe contained anything but clear fluid, the waste was sent to cytology, paired with the EBUS-TBNA needle sample from the same node. 38 patients had samples taken from both waste material and via the EBUS-TBNA needle (47 nodes in total). Malignancy was seen in 26 nodes, granulomata in 9, and no disease seen in 12 (1 insufficient sample, 10 true negatives and 1 false negative). Of the 27 malignant nodes, the EBUS-TBNA needle sample contained diagnostic material in 25 samples (sensitivity 96%). The waste sample contained diagnostic material in 23 samples (sensitivity 85%); in 13 of these, the waste sample was felt to have either as much or more diagnostic material than the sample obtained from the EBUS-TBNA needle.
Conclusion: Waste material obtained during EBUS contains diagnostic material in the majority of cases, and in our cohort contained at least as much material as the corresponding EBUS-TBNA needle sample in 50% of samples. This is important when considering the rising amount of tissue required by oncologists for molecular testing.

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