The aim of this study was to describe the cytological features of patients with significant occupational dust exposure presenting with benign bilateral mediastinal and hilar lymphadenopathy (BHL).
A retrospective cohort study including patients undergoing EBUS-TBNA for investigation of benign BHL. Patient characteristics, dust exposure history, radiology, and cytology samples from EBUS-TBNA were assessed.
EBUS-TBNA cytology in patients with exposure showed a significant increase in the presence of birefringent fibers (60.7% vs 19.2%, P = 0.001) and intracellular carbon pigment (75.0% vs 28.9%, P = 0.001) compared with patients without exposure. The presence of these two features together yielded a sensitivity of 53.6% and a specificity of 88.5%.
In patients with BHL and a history of occupational dust exposure, the presence of birefringent fibers and intracellular carbon pigment in EBUS-TBNA cytology samples may assist in a diagnosis of lymphadenopathy due to occupational dust exposure.
Department of Thoracic Medicine, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia (Dr Pattison, Dr Cook, Dr Fielding), Department of Anatomical Pathology, Pathology Queensland, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia (Dr Singh, Dr Nandakumar), and Department of Nuclear Medicine and Specialised PET Services, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia (Dr. Ravi Kumar).
Address correspondence to: Andrew Pattison, FRACP, Department of Thoracic Medicine, Royal Brisbane & Women's Hospital, Butterfield St, Herston, QLD, Australia, 4006 (email@example.com).
No funding sources or pharmaceutical/industry support was provided for this study.
Pattison, Cook, Singh, Nandakumar, Ravi Kumar, and Fielding have no relationships/conditions/circumstances that present potential conflict of interest.
The JOEM editorial board and planners have no financial interest related to this research.