{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:06:16Z","timestamp":1776085576241,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique widely used for mediastinal staging and diagnosis in patients with lung cancer and extrathoracic malignancies. This study aimed to evaluate patient and procedural factors associated with malignant histopathological outcomes in individuals undergoing EBUS-TBNA for intrathoracic lymphadenopathy across three malignancy groups: primary lung cancer, extrathoracic solid organ malignancy, and hematological malignancy. Materials and Methods: This retrospective descriptive study included patients who underwent EBUS-TBNA at Ankara Bilkent City Hospital between March 2019 and December 2023. Demographic characteristics, histopathological findings, procedural details, additional sampling techniques, and imaging parameters, including FDG SUVmax values from pre-procedural PET-CT, were recorded. Histopathological outcomes were categorized as malignant or non-malignant. Binary and multinomial logistic regression analyses were performed to identify independent predictors of malignancy and to differentiate between malignancy groups and lung cancer subtypes. Results: A total of 776 patients underwent EBUS-TBNA, and 667 were included after excluding non-diagnostic samples. Malignancy was detected in 274 patients, including primary lung cancer (n = 213, 77.7%), extrathoracic malignancy (n = 43, 15.7%), and hematological malignancy (n = 18, 6.6%). Of the included patients, 426 (63.9%) were male; the median age was 63 (IQR = 16) years. Older age (OR = 1.03, 95% CI = 1.02\u20131.05, p &lt; 0.001), male sex (OR = 2.05, 95% CI = 1.43\u20132.93, p &lt; 0.001), and larger lymph node size (OR = 1.09, 95% CI = 1.06\u20131.11, p &lt; 0.001) were independently associated with malignant outcomes. Younger age, female sex, and smaller lymph node size were associated with extrathoracic malignancy compared to primary lung cancer, while younger age was the only predictor of hematological malignancy. Larger lymph node size was inversely associated with adenocarcinoma and squamous cell carcinoma compared with small cell lung cancer. Conclusions: Older age, male sex, and larger lymph node size independently predict malignant EBUS-TBNA outcomes. Younger age and female sex favor extrathoracic malignancy, whereas small cell lung cancer is associated with more extensive nodal involvement. Additional bronchoscopic techniques may enhance diagnostic accuracy in selected patients.<\/jats:p>","DOI":"10.3390\/medicina62040727","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T10:20:16Z","timestamp":1775816416000},"page":"727","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Mediastinal Metastases of Primary Lung Cancer Versus Extrathoracic Malignancies in Patients Obtained with Endobronchial Ultrasonography-Guided Transbronchial Needle Aspiration Biopsy: A Single-Center Retrospective Study"],"prefix":"10.3390","volume":"62","author":[{"given":"Umran","family":"Ozden Sertcelik","sequence":"first","affiliation":[{"name":"Department of Chest Diseases, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06800 Ankara, T\u00fcrkiye"},{"name":"Department of Chest Diseases, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebru Sengul","family":"Parlak","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"},{"name":"Department of Chest Diseases, Faculty of G\u00fclhane Medicine, Health Sciences University, 06010 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Habibe","family":"Hezer","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1244-4530","authenticated-orcid":false,"given":"Eren Goktug","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4301-0586","authenticated-orcid":false,"given":"Ahmet","family":"Sertcelik","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06800 Ankara, T\u00fcrkiye"},{"name":"Department of Infectious Diseases and Clinical Microbiology, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aysegul","family":"Karalezli","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06800 Ankara, T\u00fcrkiye"},{"name":"Department of Chest Diseases, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1097\/JTO.0b013e318223c3fe","article-title":"Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of intrathoracic lymphadenopathy in patients with extrathoracic malignancy: A multicenter study","volume":"6","author":"Navani","year":"2011","journal-title":"J. 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