GeneXpert Analysis Combined with EBUS-TBNA Increased Diagnostic Yield of TB Mediastinal Lymphadenitis

Piamlarp Sangsayunh MD1, Kittima Bangpattanasiri MD1

Affiliation : 1 Chest Division, Central Chest Institute of Thailand, Nonthaburi, Thailand

Objective : To evaluate yield of GeneXpert combined endobronchial ultrasound with transbronchial needle aspiration [EBUS-TBNA] for detect mediastinal TB lymphadenitis in suspected TB patients.
Materials and Methods : Suspected mediastinal TB lymphadenitis patients who visited Central Chest Institute of Thailand between October 2013 and September 2014 were included. EBUS-TBNA was done. They were assessed by direct smear, liquid culture, GeneXpert, and tissue from node. Mediastinoscopy and/or clinical resolving were followed.
Results : Thirty suspected mediastinal TB lymphadenitis patients who needed EBUS-TBNA were included. Six of them had no (cid:976)inal diagnosis as they denied to be investigated, so only 24 patients were studied. De(cid:976)inite diagnosis were 12 TB, 2 sarcoidosis, 8 carcinoma, 1 Hodgkin lymphoma, 1 substernal goiter. Four of 12 TB patients showed pattern of granulomatous in(cid:976)lammation/ caseous granuloma in EBUS-TBNA, two of four granulomatous in(cid:976)lammation/caseous granuloma samples were positive in GeneXpert. GeneXpert was positive in four patients of 12 TB patients (33%). GeneXpert combined with EBUS-TBNA was positive in (cid:976)ive of 12 TB patients. No sample was positive on direct smear or liquid cultures.
Conclusion : GeneXpert combined with EBUS-TBNA has more bene(cid:976)its than node direct smear and standard culture.

Keywords : GeneXpert, BUS-TBNA, TB lymphadenitis

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