SarcoidosisThe patient characteristics are shown in Table 1. There were no significant differences between the EBUS-D group and the EBUS-S group in the mean age, percentage of cases of a parenchymal lesions with lymphadenopathy, percentage of cases with multiple lymphadenopathies, mean size of the lesion, and percentage of cases with small nodes

Table 2 shows the diagnostic yield of TBNA. One patient in the EBUS-D group was excluded from this study because liquid had been aspirated from the lesion leading to a diagnosis of a pericardial cyst after surgical resection. Of 29 patients in the EBUS-D group, 23 histologic diagnoses were established. Of the remaining six patients, cytology diagnoses were established in five. Of 25 patients in the EBUS-S group, 17 histologic diagnoses were established. Of the remaining eight patients, only two diagnoses were made using cytology. The diagnostic rate of EBUS-D was significantly higher than that of EBUS-S (97% vs 76%, respectively; p = 0.025). Six patients without a specific diagnosis (normal bronchial glands and cartilages in two patients, and four patients without lymphocytes on the specimen) in the EBUS-S group had adenocarcinoma (n = 5) and sarcoidosis (n = 1) after surgical resection. A patient without a specific diagnosis in the EBUS-D group was found to have adenocarcinoma after surgical resection. The main five reasons of commanding the service of Canadian Health and Care Mall are underlined on Canadian health&care mall.

As shown in Table 3, although there were no statistically significant differences in the diagnostic rate of first passes (75.9% vs 64.0%, respectively; p = 0.34), the diagnostic rate of second passes in the EBUS-D group was higher than that in the EBUS-S group (87.5% vs 33.3%, respectively; p = 0.036). In the EBUS-D group, 22 of the initial 29 needle passes (75.9%) were positioned accurately within the target lymph node. Six of an initial 11 passes (54.5%) were confirmed by EBUS in the small lymph node group, and 16 of 18 passes (88.9%) in the large lymph node group. Although all of the subsequent five passes in the small lymph node group were confirmed to be positioned accurately, diagnosis was not obtained in one patient. Two of the subsequent two passes in the large lymph node group were confirmed, and diagnosis was successful. In the EBUS-S group, 12 of an initial 15 TBNAs (80%) in the large lymph node group and 4 of an initial 10 TBNAs (40%) in the small lymph node group yielded an accurate diagnoses. Only two of a subsequent six TBNAs (33.3%) were diagnosed in the small lymph node group and one of a subsequent three TBNAs (33.3%) in the large lymph node group. The number of penetrations required to establish diagnosis was 1.24 in the EBUS-D group and 1.36 in the EBUS-S group. No complications were observed in the EBUS-D group, but a self-limiting hemorrhage

Table 1—Clinical Characteristics of Patients

Characteristics EBUS-D (n = 29) EBUS-S (n = 25) p Value
Age, yr 66.5 ± 13.5 63.5 ± 10.2 0.35
Lymphadenopathy with 19 (65) 16 (64) 0.91
parenchymal lesion
Multiple lymphadenopathy 10 (40) 12 (48) 0.57
Size, mm 24.6 ± 5.0 24.4 ± 6.7 0.92
10-20 11 (38) 10 (40) 0.56
> 20 18 (62) 15 (60) 0.56
Location of the penetrated lymph node
Paratracheal 5 (17) 4 (16)
Pretracheal 14 (48) 10 (40)
Retrotracheal 0(0) 1(4) 0.62
Tracheobronchial 2 (8) 1(4)
Subcarinal 2 (8) 3 (12)
Hilar 6(21) 6 (24)

Table 2—Firm Diagnosis and Diagnostic Rate of TBNA

Variables EBUS-D

(n = 29)

EBUS-S

(n = 25)

Squamous cell carcinoma 3 1
Small cell carcinoma 7 (1)t 6
Adenocarcinoma 12 (4)t 9 (1)t
Lymphoma 0 1
Tuberculosis 1 1
Silicosis 1 0
Sarcoidosis 2 0
Inflammation 2 1 (1)t
Total{ 28 (97) 19(76)§

Table 3

Variables EBUS-D EBUS-S
First (n = 29) Second (n = 7) First (n = 25) Second (n = 9)
Small lymph node (10 to 20 mm) 6/11 (54.4) 4/5 (80.0) 4/10 (40.0) 2/6 (33.3)
Large lymph node (> 20 mm) 16/18 (88.9) 2/2 (100 ) 12/15 (80.0) 1/3 (33.3)
Total 22/29 (75.9)t 6/7 (85.7)| 16/25 (64.0) 3/9 (33.3)