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Introduction: Image and metabolic techniques (CT, PET and EBUS) during the study of lung cancer set the pathway to sampling mediastinal LN using EBUS. Discrimination between benign or malignant nature of LN is complex, because there are inconsistent data on morphological and metabolic expression of NNLN. Findings integration from the diferents techniques may guide the probability of benign nature, direct the sampling method and estabish the priority to mediastinoscopy (MED) Aim: The aim of our study was describe the NNLN profile compared with CT, PET/CT and the EBUS in patient with CP and correlate those findings Methods: Period:January 2012-March 2015. We include 86 LN of 81 patients (31 NNLN and 55 NLN) with LC. All patients dispose TC and PET before EBUS-TBNA. The analyzed variables: CT/PET findings, location and size of primary tumor and LN ultrasound signs of studied LN. All results were confirmed by MED. We analyze and correlate findings in NNLN and neoplastic LN Results: No difference in size, SUV and localization of primary tumor between NNLN and NLN. The mean (x - ) size in NNLN and NLN were 17,97 mm vs 23,64 mm respectively. The x - SUV were 4,05 in NNLN (16,5% with - SUVratio (LN SUV / primary Tu SUV) were 0.46 in NNLN (54,1 with r = -0.43 p=0,03) and positive in NLN (r=0.41, p=0,02). The central hilliar sign was the only benign sign, with low sensivity (28%) Conclusions: The presentation of NNLN in patients with LC is heterogeneous with no correlation between image and metabolic test. Lack of concordance in all techniques is suggestive of a benign nature.

Introduction: The diagnostic profitability of EBUS-TBNA is highly variable between different studies. Failure to identify those factors depending on the technique and the underlying neoplasia which can determine it. Materials and Methods: We included 162 patients with LC between the periods January 2010 to September 2014. The analyzed variables: histology, CT/PET findings, location and size of primary tumor, ultrasound descriptions of mediastinal lymph nodes (LN), technical aspects of EBUS-TBNA. The diagnostic accuracy was expressed as sensitivity, specificity, PPV and NPV.Cervical mediastinoscopy and surgical resection were considered as reference standard. Due the important diagnostic implication of the NPV, we focus on analyze the factors which can condition it. Results: Of the 162 patients included, 153 were NSCLC and 9 SCLC. The prevalence was 72% and NPV 72%. The total of false negative results (FN) was 18 patients . On 7/18 FN, a systematic sampling was not performed. In 4/18 FN, the cytology was reported as not representative of lymphadenopathy (LN), these being predominantly left LN. In 7/18, a FN result was obtained even with adequate sampling and representative cytology. Most of these LN were accessible on the right side and showed ultrasound evidence of necrosis in five of them. In one of those cases the diagnosis was by EUS-TBNA. Conclusions: During EBUS-TBNA, it´s necessary to execute a systematic sampling of all visible LN. The access of left nodes stations could be improved complementing the study with EUS-TBNA. In the absence of ROSE, with ultrasound evidence of necrosis, the LN sampling area should be better selected and / or increase the number of punctures.