Benign mediastinal/hiler lenfadenopatilerde etyoloji
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Date
2019-11-11
Authors
Özlü, Tevfik
Bülbül, Yılmaz
Öztuna, Funda
Özsu, Savaş
Tekinbaş, Celal
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Çalışmamızda benign mediastinal/hiler lenfadenopati saptanan hastalar takip edilerek lenfadenopatiye neden olan hastalıkların dağılımı incelenmiştir. Çalışmamız, Mayıs 2015 ile Haziran 2016 tarihleri arasında prospektif olarak yürütüldü. Çalışmaya mediastinal/hiler lenfadenopati nedeni ile EBUS/ Mediastinoskopi/ Torakoskopi yapılan olgular alındı ve başlangıçta biyopside malignite saptanan hastalar çalışmadan çıkarıldı. Çalışmaya dahil edilen benign mediastinal/hiler LAP saptanan 93 hastanın %59.1 (55)’i kadın, %40.9 (38)’u erkek, yaş ortalaması 55.1 (±12.6) idi. Seksen üç hastaya Endobronşiyal Ultrason Eşliğinde Transbronşiyal İğne Aspirasyonu (EBUS TBİA), 7 hastaya mediastinoskopi, 2 hastaya Video-asiste torakoskopik cerrahi (VATS) ve 1 hastaya torakotomi yapıldı. Hastaların %53.8 (50)’inde sarkoidoz, %12.9 (12)’unda antrakoz, %5.1 (5)’inde tüberküloz, %4.3 (4)’ünde silikozis, %1.1 (1)’inde churg strauss sendromu, %1.1 (1)’inde hipersensitivite pnömonisi, %1.1 (1)’inde enfeksiyon, %1.1 (1)’inde kanser, %19.4 (18)’ünde nedeni bilinmeyen lenfadenopati bulundu. Çalışmamızdaki esas bulgu benign mediastinal/hiler lenfadenopatinin en yaygın nedeninin sarkoidoz olarak bulunmasıdır. Enfeksiyöz nedenlerden tüberküloz ise 3. sıklıkta LAP nedeni olarak bulunmuştur. Ayrıca granülomatöz lenfadenitin benign mediastinal/hiler lenfadenopatilerin yarısından fazlasını oluşturduğu görülmüştür. Mediastinel/hiler LAP’lerin büyük oranda EBUS TBİA yöntemiyle örneklenebildiği saptanmıştır. Ayırıcı tanının yapılamadığı olgularda takip ile tanıya gidilebileceği de anlaşılmaktadır.
Our study was conducted as prospectively between May 2015 and June 2016. Cases that underwent EBUS/ Mediastinoscopy / Thoracoscopy with the diagnosis of mediastinal/hilar lymphadenopathy were included in the study and patients who were diagnosed to have malignancy in the initial biopsy were excluded from the study. The included 93 cases consisted of 40.9% men (38) and 59.1% women (55) with a median age of 55.1 (±12.6) years. Patients underwent Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS TBNA) (83 patients), mediastinoscopy (7 patients), video-assisted thoracic surgery (2 patients) and thoracotomy (1 patient). The final diagnosis of the patients was accepted to be sarcoidosis in 50 (53.8%), anthracosis in 12 (12.9%), tuberculosis in 5 (5.1%), silicosis in 4 (4.3%), churg strauss syndrome in 1 (1.1%), hypersensitivity pneumonia in 1 (1.1%), infectious in 1 (1.1%), malignancy in 1 (1.1%) and uncertain in 18 (19.4%). The main findings of this study revealed that sarcoidosis was the most common cause for benign mediastinal/hilar lymphadenopathy. Tuberculosis was the third most common cause of benign mediastinal/hilar LAP. Furthermore, granulomatous lymphadenitis comprised more than half of benign mediastinal / hilar lymphadenopathy. It has been found that mediastinal/hilar LAP can be sampled by EBUS TBNA method to a large extent. In cases with impossible differential diagnosis, follow-up of patients may direct one to diagnosis in time.
Our study was conducted as prospectively between May 2015 and June 2016. Cases that underwent EBUS/ Mediastinoscopy / Thoracoscopy with the diagnosis of mediastinal/hilar lymphadenopathy were included in the study and patients who were diagnosed to have malignancy in the initial biopsy were excluded from the study. The included 93 cases consisted of 40.9% men (38) and 59.1% women (55) with a median age of 55.1 (±12.6) years. Patients underwent Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS TBNA) (83 patients), mediastinoscopy (7 patients), video-assisted thoracic surgery (2 patients) and thoracotomy (1 patient). The final diagnosis of the patients was accepted to be sarcoidosis in 50 (53.8%), anthracosis in 12 (12.9%), tuberculosis in 5 (5.1%), silicosis in 4 (4.3%), churg strauss syndrome in 1 (1.1%), hypersensitivity pneumonia in 1 (1.1%), infectious in 1 (1.1%), malignancy in 1 (1.1%) and uncertain in 18 (19.4%). The main findings of this study revealed that sarcoidosis was the most common cause for benign mediastinal/hilar lymphadenopathy. Tuberculosis was the third most common cause of benign mediastinal/hilar LAP. Furthermore, granulomatous lymphadenitis comprised more than half of benign mediastinal / hilar lymphadenopathy. It has been found that mediastinal/hilar LAP can be sampled by EBUS TBNA method to a large extent. In cases with impossible differential diagnosis, follow-up of patients may direct one to diagnosis in time.
Description
Ulusal Akciğer Sağlığı Kongresi’nde poster bildiri olarak sunulmuştur (14-18 Mart 2018, Antalya).
Keywords
Benign lenfadenit, Sarkoidoz, Granülomatöz lenfadenit, Benign lymphadenitis, Sarcoidosis, Granulomatous lymphadenitis
Citation
Erbay, M. vd. (2019). "Benign mediastinal/hiler lenfadenopatilerde etyoloji". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 45(3), 311-315.