Objective: To evaluate yield of GeneXpert combined endobronchial ultrasound with transbronchial needle aspiration [EBUS-TBNA] for detect mediastinal TB lymphadenitis in suspected TB patients.

Materials and Methods: Suspected mediastinal TB lymphadenitis patients who visited Central Chest Institute of Thailand between October 2013 and September 2014 were included. EBUS-TBNA was done. They were assessed by direct smear, liquid culture, GeneXpert, and tissue from node. Mediastinoscopy and/or clinical resolving were followed.

Results: Thirty suspected mediastinal TB lymphadenitis patients who needed EBUS-TBNA were included. Six of them had no final diagnosis as they denied to be investigated, so only 24 patients were studied. Definite diagnosis were 12 TB, 2 sarcoidosis, 8 carcinoma, 1 Hodgkin lymphoma, 1 substernal goiter. Four of 12 TB patients showed pattern of granulomatous inflammation/caseous granuloma in EBUS-TBNA, two of four granulomatous inflammation/caseous granuloma samples were positive in GeneXpert. GeneXpert was positive in four patients of 12 TB patients (33%). GeneXpert combined with EBUS-TBNA was positive in five of 12 TB patients. No sample was positive on direct smear or liquid cultures.

Conclusion: GeneXpert combined with EBUS-TBNA has more benefits than node direct smear and standard culture.

Keywords: GeneXpert, BUS-TBNA, TB lymphadenitis