Cytology versus histology in the primary diagnosis of lymphoma located in the mediastinum

Abstract Background Endobronchial ultrasound-guided transbronchial needle aspirations (EBUS-TBNA) are well-established for staging lung cancer. A growing number of publications report on lymphoma diagnosis via EBUS-TBNA acquired cytology; however, current guidelines recommend histological diagnosis. Research on the value of EBUS-TBNA acquired cytology versus surgical acquired histology in the diagnosis of lymphoma is lacking. Methods We conducted a retrospective review of patients with mediastinal lymphoma diagnosed between 2010 and 2016. Mediastinal lymphadenopathy was accessible through both EBUS-TBNA and surgical procedures. All data were extracted from our clinic's medical database and analyzed. Results Fifty-one patients newly diagnosed with lymphoma in the mediastinum were identified (median age: 43.5 years; mean age 48.6±20.6 years). A minimally invasive procedure was performed as a first diagnostic step in 29 patients; whereas, surgical biopsy was performed in the remaining 22. The time to final diagnosis was significantly longer if a minimally invasive procedure was performed first compared with a surgical procedure (mean 44 days, median 38 days vs. mean 16 days, median 8 days p Conclusions We demonstrate that surgical biopsies are safe and well-tolerated for lymphoproliferative disease diagnosis and lead to a final diagnosis in the shortest possible timeframe. The number of unnecessary procedures was significantly fewer if a surgical biopsy was performed as the first step.