ArticleCHEST pulmonary2026
Ability of Rapid On-Site Cytologic Evaluation to Guide Lymph Node Sampling Reliably During Bronchoscopy for Granulomatous Disease.
Article in CHEST pulmonary, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Rapid on-site cytologic evaluation (ROSE) during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has the potential to influence specimen acquisition, but ROSE's ability to inform decision-making during bronchoscopy for granulomatous disease has not been assessed. Research Question: Does ROSE detect granulomas accurately enough to guide lymph node sampling reliably during EBUS-TBNA for granulomatous disease? Study Design and Methods: We retrospectively studied individuals who underwent EBUS-TBNA with ROSE performed by cytotechnologists from 2013 through 2021 and either (1) a granuloma was identified by ROSE or final cytologic review or (2) they received a diagnosis of granulomatous disease during clinical follow-up. We assessed the accuracy of ROSE and EBUS-TBNA final cytologic results for a diagnosis of granulomatous disease during serial lymph node sampling. Results: Granulomatous disease was diagnosed in 176 individuals, including 150 patients with a granuloma identified by EBUS-TBNA final cytologic analysis and 26 patients who received a diagnosis by other means. Sarcoidosis was diagnosed in 143 patients and miscellaneous diseases were diagnosed in 33 patients. Results of ROSE and final cytologic analysis were concordant in 76% of procedures, similar to studies that have used cytopathologists. Using final cytologic analysis as the gold standard, ROSE showed a diagnostic yield of 0.74, false-positive rate of 2%, and positive and negative predictive values of 0.97 and 0.38, respectively. Final cytologic analysis showed a diagnostic sensitivity of 0.85 with a cumulative diagnostic yield of 98% when sampling just 3 lymph nodes. Although uncommon, false-positive diagnoses resulting from ROSE were less frequent when > 1 lymph node was sampled. Interpretation: ROSE showed limited practical value in guiding lymph node sampling in granulomatous disease. Diagnostic yield did not improve by sampling > 3-4 lymph nodes in patients with negative ROSE findings, and false-positive results are avoided by sampling at least 2 nodes. Negative ROSE results should not discourage submitting nodal aspirates for microbiologic studies when suspicion for granulomatous disease is high.
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