EUS-FNA for mediastinal lesions of unknown aetiology: A 4-year experience from a single centre

Aim: Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) allows access to the posterior mediastinum and tissue acquisition under real-time ultrasound guidance through the oesophageal wall. The aim of this study was to report the experience of mediastinal EUS-FNA in a large UK tertiary centre. Methods: The study included all patients who underwent mediastinal EUS-FNA in our institution from January 2008 to December 2011. Patient and procedure related data were collected from endoscopy reports. Cytology and microbiology culture reports were compared to the final clinical diagnoses made during the follow-up. We calculated sensitivity, specificity, positive and negative predictive value (PPV&NPV) of mediastinal EUS-FNA for most common conditions. Results: 195 patients (n=195, males 65%, mean age 58.6) underwent mediastinal EUS-FNA during the study period. Mean size of the lesions was 15.82mm (range 3.9-43) in short axis and 28.23mm (range 8-60) in long axis. Sub-carinal lymph nodes (LN) were the commonest (145/195, 70.3%) target lesion. View this table: Table 1:Overall and condition specific results of mediastinal EUS-FNA Conclusion: Our large series shows that mediastinal EUS-FNA has high sensitivity and specificity for malignancy and sarcoidosis. With overall high sensitivity & specificity, it should be a useful tool in the assessment of mediastinal pathology.