Diagnostic Use of Endobronchial Ultrasound (EBUS) Guided Transbronchial Needle Aspiration (TBNA) in Intrathoracic Tuberculosis

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is widely used for sampling mediastinal and intraparenchymal lymph nodes.This study aims to determine the diagnostic sensitivity of EBUS-TBNA in tuberculosis (TB) diagnosis and to establish the optimal number of punctures required for accurate sampling.Methods: Patients who underwent EBUS-TBNA as the initial diagnostic procedure between August 2020 and October 2023 in the pulmonology clinic were retrospectively evaluated.The study included patients with pathological findings of granulomatous lymphadenitis and a confirmed TB diagnosis.Biopsy materials were analyzed for acid-fast bacilli (AFB), mycobacterial culture, PCR results, and pathology reports.Results: Among 595 patients who underwent EBUS-TBNA as their initial diagnostic procedure, 101 (16.9%) were diagnosed with TB.Of these, 72 patients (71.28%) were diagnosed directly via EBUS-TBNA, whereas additional bronchoscopic procedures were required for 29 patients (28.72%).The mean size of the sampled lymph nodes was 1.90.4cm, with an average of 5.46 aspirations performed per lymph node.The prevalence of TB among patients who underwent EBUS-TBNA was 16.9%, and the sensitivity of EBUS-TBNA in diagnosing TB was 71.28%.Discussion and Conclusion: EBUS-TBNA is a safe and effective method for diagnosing intrathoracic tuberculous lymphadenitis.An average of five punctures per lymph node provided an optimal sample size for microbiological evaluation, thereby enhancing diagnostic performance.