The Diagnostic Utility of Endobronchial Ultrasound-Guided Fine-Needle Aspiration Cytology (EBUS-FNAC) for Thoracic Lymphadenopathy: A Correlation Study With Radiological Findings.

BACKGROUND: Thoracic lymph node enlargement is a common diagnostic finding and may be attributed to a broad spectrum of diseases, including granulomatous disorders, infections, and advanced malignancy. Although radiological modalities such as computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) are widely employed for preliminary noninvasive assessment, their specificity in distinguishing benign from malignant cases remains restricted due to overlapping imaging appearance. Endobronchial ultrasound-guided fine-needle aspiration cytology (EBUS-FNAC) has become an important minimally invasive diagnostic modality for mediastinal and hilar lymph nodes. This study aims to evaluate the diagnostic effectiveness of EBUS-FNAC in thoracic lymphadenopathy and examine its correlation with CT and PET-CT findings.

METHODS: Patients whose EBUS FNAC samples were received in Cytology section of SKM pathology lab in a 1-year period were evaluated.

RESULTS: A total of 174 patients were included. CT scan of all patients showed thoracic lymphadenopathy. Malignant pathology was identified in 45/174 (25.8%) patients, granulomatous disease in 45/174 (25.8%) patients, reactive lymphadenopathy in 83/174 (47.7%) patients, and 1 patient's sample was concluded as inadequate (0.57%). Significant correlation was observed between lymph node size > 15 mm and disease involvement (p < 0.001).

CONCLUSIONS: EBUS-FNAC is a safe diagnostic modality with high sensitivity and specificity for assessing thoracic lymph node enlargement. Integration of radiological features and cytological findings further strengthens diagnostic confidence. It should be adopted as a first-line diagnostic technique before surgical intervention.