Related Experiment Video For Mediastinal lymphadenopathy
Updated: Aug 30, 2025
Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
Endosonographic characteristics of mediastinal lymph nodes for predicting malignancy in high tuberculosis burden
Kuruswamy Thurai Prasad1, Valliappan Muthu1, Inderpaul Singh Sehgal1
1Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Background:
Whether sonographic features of mediastinal lymph nodes can differentiate malignancy from tuberculosis remains unclear.
Research Design And Methods:
We retrospectively identified subjects with a confirmed diagnosis of tuberculosis or malignancy on endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Our primary objective was to compare the endosonographic characteristics of lymph nodes on EBUS between tuberculosis and malignancy. Our secondary objective was to assess the diagnostic performance of endosonographic characteristics in predicting malignancy.
Results:
We included 774 subjects (1,498 lymph nodes) with a confirmed diagnosis of tuberculosis (n = 497) or malignancy (n = 277). Distinct lymph node margins (84.1% vs. 93.8%, P < 0.001) and coagulation necrosis sign (11.2% vs. 29.8%, P < 0.001) were less common in malignancy than tuberculosis. The absence of central hilar structure had the highest sensitivity (92.1%) for malignancy. Endosonographic characteristics had poor specificity for malignancy(round shape and coagulation necrosis sign, 77.3% and 70.2%. In multivariate analysis, coagulation necrosis sign was associated with a lower odds of malignancy (odds ratio 0.45 [95% confidence intervals, 0.21-0.95]).
Conclusions:
Endosonographic characteristics, such as round shape and the coagulation necrosis sign, are not specific for malignancy in high tuberculosis prevalence areas.
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