Endobronchial-ultrasound guided transbronchial needle aspiration (EBUS-TBNA) in Tuberculous mediastinal lymphadenopathy

<b>Background:</b> Tuberculous mediastinal lymphadenopathy is a common presentation of extrapulmonary tuberculosis in high TB prevalence countries. Establishing an accurate pathological diagnosis is difficult due to the relatively inaccessible location. EBUS-TBNA is a safe and efficacious modality for the evaluation of mediastinal lymphadenopathy. <b>Methods:</b> We retrospectively reviewed case records of patients undergoing EBUS-TBNA at our center who received a final diagnosis of mediastinal tuberculosis. Procedures were performed under moderate sedation. Aspirates were subjected to cytopathological analysis, acid-fast staining, and MTB-RIF GeneXpert assay. The primary objective was to evaluate the diagnostic accuracy and safety of EBUS-TBNA in the diagnosis of tuberculous mediastinal lymphadenopathy. <b>Results:</b> 179 patients who received a final diagnosis of tuberculous mediastinal lymphadenopathy were identified. The mean age was 35 ± 16.3 years. A total of 260 nodal stations were sampled in 179 patients. The most commonly sampled lymph node station was lower right paratracheal 4R (40.4%), followed by subcarinal 7 (37.3%). Adequate aspirates were obtained in 154 patients (86%). EBUS-TBNA was diagnostic for TB in 133 patients out of 179 patients (74.3%). Minor complications were observed in 2 patients. <b>Conclusions:</b> EBUS-TBNA is a safe and efficacious modality for the diagnosis of tuberculous mediastinal lymphadenopathy.