Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2025; 13(22): 105596
Published online Aug 6, 2025. doi: 10.12998/wjcc.v13.i22.105596
Mediastinal lymphadenopathy: Causes, symptoms and factors predicting good yield of endoscopic ultrasound-guided biopsy
Abbas A Tasneem, Nasir H Luck, Muhammed Mubarak
Abbas A Tasneem, Nasir H Luck, Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Author contributions: Tasneem AA, Luck NH, and Mubarak M contributed equally to the conception and study design, performed relevant research and participated in primary and final drafting; Luck NH, and Mubarak M critically reviewed and approved the final manuscript.
Institutional review board statement: The present study was exempted from the Institutional Review Board of Sindh Institute of Urology and Transplantation and was approved by the Head of the Gastroenterology and Hepatology Department, and the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent statement: All patients provided written informed consent.
Conflict-of-interest statement: All authors declared that they have no conflict of interest related to this work.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammed Mubarak, Professor, Department of Histopathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Sindh, Pakistan. drmubaraksiut@yahoo.com
Received: January 30, 2025
Revised: March 29, 2025
Accepted: April 11, 2025
Published online: August 6, 2025
Processing time: 105 Days and 16.1 Hours
Core Tip

Core Tip: Endoscopic ultrasound effectively diagnoses causes of enlarged mediastinal lymph nodes (MLNs), including tuberculosis, anthracosis, and metastatic diseases, with over half of cases lacking chest-related symptoms. Factors predicting good diagnostic yield include MLN size > 12 mm, subcarinal location, use of fine-needle biopsy over fine-needle aspiration, and satisfactory macroscopic on-site evaluation (MOSE). Larger MLNs and optimal MOSE were the strongest predictors on multivariate analysis, emphasizing the importance of accurate imaging and procedural technique in achieving reliable diagnostic outcomes.