Original articleGeneral thoracicReal-Time Endobronchial Ultrasound-Guided Transbronchial Lymph Node Aspiration
Section snippets
Material and Methods
This was a retrospective analysis of 152 consecutive EBUS-TBNA procedures performed at the Medical University of South Carolina between January 1, 2005, and April 30, 2006. Our institution’s Investigational Review Board approved the study and waived the informed consent requirement. Patients met criteria for inclusion in this study if they had a primary lung mass or undiagnosed mediastinal adenopathy, or both. Rapid on-site cytopathologic evaluation was used for all procedures.
Bronchoscopy was
Results
The study included 152 patients. Demographic information is summarized in Table 1. Patient outcomes are shown in Figure 2. Of the 152 patients analyzed, 35 (23%) had benign diagnoses confirmed by EBUS-TBNA. An additional 4 patients who underwent surgical resection had benign diagnoses confirmed at pathologic examination. A diagnosis was never established in 6 of 152 patients (3.9%). Lung mass alone was an indication in 21 patients (13.8%), 49 (32.2%) had hilar or mediastinal adenopathy, or
Comment
This study shows that EBUS-TBNA is useful in diagnosing and staging intrathoracic lymphadenopathy. It reaches multiple lymph node stations, including the highest paratracheal (levels 2 and 3), paratracheal (level 4), subcarinal (level 7), and hilar nodes (levels 10 and 11). No adverse events were reported in our series. EBUS-TBNA can establish both benign and malignant diagnoses in undiagnosed intrathoracic lymphadenopathy, with or without associated lung mass. In cases of suspected primary
References (40)
- et al.
Seeking a home for PET, Part II: defining the appropriate place for positron emission tomography imaging in the staging of patients with suspected lung cancer
Chest
(2004) - et al.
Bronchoscopy and needle biopsy techniques for diagnosis and staging of lung cancer
Clin Chest Med
(2002) - et al.
Endoscopic ultrasound in lung cancer patients with a normal mediastinum on computed tomography
Ann Thorac Surg
(2004) - et al.
Endoscopic ultrasoundguided fine needle aspiration for staging patients with carcinoma of the lung
Ann Thorac Surg
(2001) - et al.
Mediastinal lymph node involvement in potentially resectable lung cancer: comparison of CT, positron emission tomography and endoscopic ultrasonography with and without fine-needle aspiration
Chest
(2003) - et al.
Esophageal endoscopic ultrasound with fine-needle aspiration with an on-site cytopathologist: high accuracy for diagnosis of mediastinal lymphadenopathy
Chest
(2005) - et al.
Endoscopic ultrasound-guided biopsy performed routinely in lung cancer staging spares futile thoracotomies: preliminary results from a randomised clinical trial
Lung Cancer
(2005) - et al.
Impact of EUS-guided FNA of enlarged mediastinal lymph nodes on subsequent thoracic surgery rates
Gastro Endosc
(2004) - et al.
One from column a: choosing between CT, positron emission tomography, endoscopic ultrasound with fine-needle aspiration, transbronchial needle aspiration, thoracoscopy, mediastinoscopy and mediastinotomy for staging lung cancer
Chest
(2003) - et al.
Comparison of endobronchial ultrasound, positron emission tomography and CT for lymph node staging of lung cancer
Chest
(2006)
Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes
Chest
Endobronchial ultrasound guided transbronchial needle aspiration for staging of lung cancer
Lung Cancer
Endoscopic and endobronchial ultrasound real-time fine-needle aspiration for staging of the mediastinum in lung cancer
Chest
Improving the inaccuracies of clinical staging of patients with NSCLC: a prospective trial
Ann Thorac Surg
Interobserver variation in the computed tomographic evaluation of mediastinal lymph node size in patients with potentially resectable lung cancerCanadian Lung Oncology Group
Chest
Can FDG-PET reduce the need for mediastinoscopy in potentially surgically resectable nonsmall cell lung cancer?
Ann Thorac Surg
Poor correspondence between clinical and pathologic staging in stage i non-small cell lung cancer: results from CALGB 9761, a prospective trial
Lung Cancer
Impact of rapid on-site cytologic evaluation during transbronchial needle aspiration
Chest
The underutilization of EUS-guided FNA in the lymph node staging of non-small cell lung cancer: perceptions of chest physicians in Wisconsin
Gastro Endosc
Conventional vs endobronchial ultrasound-guided transbronchial needle aspiration: a randomized trial
Chest
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2014, Archivos de BronconeumologiaCitation Excerpt :PPV and NPV were 75% and 88%, respectively. EBUS-TBNA has been welcomed in clinical practice as an effective instrument for lung cancer staging with an accuracy comparable to that of surgery.17–20 However, systematic aspiration of all LNs by EBUS-TBNA is a lengthy and expensive procedure.6
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