The following is a summary of “Transbronchial lymph node forceps biopsy as a novel tool in the diagnosis of mediastinal lymphadenopathy: a pilot study,” published in the February 2024 issue of Surgery by Al-Halfawy et al.
The differential diagnosis of mediastinal lymphadenopathy presents a clinical challenge, as lymph node enlargement can stem from various inflammatory, infectious, or malignant etiologies. Accurate diagnosis relies on obtaining tissue samples from the affected nodes, typically through procedures such as TBNA (EBUS or conventional) or mediastinoscopy if TBNA yields inconclusive results. This study aimed to assess the safety and feasibility of transbronchial forceps biopsy as a novel technique for diagnosing mediastinal lymphadenopathy.
The study enrolled 18 patients with confirmed mediastinal lymphadenopathy who were admitted to the Chest Department at Cairo University from December 2019 to December 2020. All patients underwent flexible bronchoscopy with conventional transbronchial needle aspiration (C-TBNA) and transbronchial forceps biopsy (LN-TBFB) from the enlarged mediastinal lymph node during the same procedure.
LN-TBFB demonstrated a favorable safety profile, with no serious complications reported. Diagnostic yield was achieved in 100% of sarcoidosis cases (7/7) and 85.7% of malignant lymph nodes (6/7). Additionally, LN-TBFB successfully diagnosed hyperactive follicular hyperplasia in three cases and tuberculous lymphadenitis in one case. C-TBNA provided diagnostic results in 71.4% of sarcoidosis cases and 42.9% of malignant cases yet failed to diagnose tuberculous lymphadenitis in one patient.
Transbronchial lymph node forceps biopsy (LN-TBFB) emerged as a safe and effective technique for diagnosing mediastinal lymphadenopathy. This minimally invasive approach presents a valuable diagnostic option for pathologically enlarged mediastinal lymph nodes, offering a viable alternative to mediastinoscopy when conventional methods yield inconclusive results.
Source: cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-024-02560-x
