ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical and Diagnostic Microbiology and Immunology
This article is part of the Research TopicDiscriminating Active Tuberculosis from Latent Tuberculosis Infection: Immunological Characteristics, Biomarkers, and Novel Approaches Volume IIView all 3 articles
EBUS-TBNA Needle Rinse Fluid: A Superior Specimen for the Molecular Diagnosis of Intrathoracic Lymph Node Tuberculosis
Provisionally accepted
Yayan Niu1Xiaohong Li1Jin yu Yan1Huafeng Song1Lin Yao1Lijuan Zhang1
Meiying Wu1
Peijun Tang1
Jun-Chi Xu2*
Yanjun Feng1- 1The Fifth People's Hospital of Suzhou, Suzhou, China
- 2Fifth People's Hospital of Suzhou, Suzhou, China
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Objectives To evaluate EBUS-TBNA needle rinse fluid versus biopsy tissue for molecular diagnosis of intrathoracic lymph node tuberculosis (TB). Methods Retrospective analysis of 63 patients with intrathoracic lymph node TB undergoing EBUS-TBNA (2018–2024). Rinse fluid and biopsy tissue were tested via TB-DNA (n=32) and Xpert MTB/RIF (n=31); positivity rates compared. Results The study cohort had a median age of 31 years (interquartile range: 25–50.1 years), with 57.1% (36/63) being male. The most frequently sampled lymph node stations were subcarinal (station 7, 82.5%) and right lower mediastinal (station 4R, 66.7%). Clinically, 82.5% (52/63) of patients had concomitant pulmonary TB, while 17.5% (11/63) presented with isolated intrathoracic lymph node TB. For TB-DNA detection, the positivity rate of rinse fluid (71.9%, 23/32) was significantly higher than that of biopsy tissue (46.9%, 15/32; χ²=4.146, P=0.042). Similarly, the Xpert MTB/RIF assay showed a higher positivity rate in rinse fluid (77.4%, 24/31) compared to tissue (41.9%, 13/31; χ²=8.11, P=0.004). Conclusions EBUS-TBNA rinse fluid demonstrates higher sensitivity than biopsy tissue for intrathoracic lymph node TB via TB-DNA/Xpert MTB/RIF. Routine rinse fluid testing improves diagnostic yield.
Keywords: EBUS-TBNA, Lymph node tuberculosis, Molecular diagnosis, TB-DNA, Xpert MTB
Received: 29 Oct 2025; Accepted: 10 Dec 2025.
Copyright: © 2025 Niu, Li, Yan, Song, Yao, Zhang, Wu, Tang, Xu and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jun-Chi Xu
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