The Contribution of Cell Blocks in the Diagnosis of Mediastinal Masses and Hilar Adenopathy Samples From Echobronchoscopy

作者：Lourido Cebreiro Tamara; Leiro Fernandez Virginia; Tardio Baiges Antoni; Botana Rial Maribel; Nunez Delgado Manuel; Jesus Alvarez Martin M; Fernandez Villar Alberto^*

来源：Archivos de Bronconeumologia, 2014, 50(7): 267-271.

DOI：10.1016/j.arbres.2013.11.022

• Endobronchial ultrasound
• Transbronchial aspiration
• Cell block
• Mediastinal and hilar adenopathies
• Neoplastic disease

Background: Cell block material from puncture can be obtained with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in many cases. The aim of this study was to analyse the value of additional information from cell blocks obtained with EBUS-TBNA samples from mediastinal and hilar lymph nodes and masses. %26lt;br%26gt;Methods: Review of pathology reports with a specific diagnosis obtained from EBUS-TBNA samples of mediastinal or hilar lesions, prospectively obtained over a two-year period. The generation of cell blocks from cytology needle samples, the contribution to morphological diagnosis, and the possible use of samples for immunohistochemistry were analysed. %26lt;br%26gt;Results: One hundred and twenty-nine samples corresponding to 110 patients were reviewed. The diagnosis was lung cancer in 81% of cases, extrapulmonary carcinoma in 10%, sarcoidosis in 4%, lymphoma in 2.7%, and tuberculosis in 0.9%. Cell blocks could be obtained in 72% of cases. Immunohistochemistry studies on the cell blocks were significantly easier to perform than on conventional smears (52.6% vs. 14%, P%26lt;.0001). In 4 cases, the cell block provided an exclusive morphological diagnosis (3 sarcoidosis and one metastasis from prostatic carcinoma) and in 3 carcinomas, subtype and origin could be identified. Exclusive diagnoses from the cell block were significantly more frequent in benign disease than in malignant disease (25% vs 0.9%, P=.002). %26lt;br%26gt;Conclusions: Cell blocks were obtained from 72% of EBUS-TBNA diagnostic procedures. The main contributions of cell blocks to pathology examinations were the possibility of carrying out immunohistochemical staining for the better classification of neoplasms, especially extrapulmonary metastatic tumours, and the improved diagnosis of benign lesions.

• 出版日期2014-7