Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed intrathoracic lesions

Abstract

Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-FNA) is a minimally invasive method used routinely for mediastinal staging of patients with lung cancer. We have used it in 135 consecutive patients with a radiologically suspicious intrathoracic lesion that remained undiagnosed despite bronchoscopy and CT-guided fine-needle aspiration (CT-FNA). There was no operative mortality or surgical complications. In 98 patients with a suspicious lesion in the lung parenchyma, adequate tissue was obtained in 83 patients (85%) and in 37 patients with enlarged lymph nodes or a mediastinal tumor adequate tissue was obtained in 35 cases (95%). However, a final diagnosis was only reached in 45% of the patients and further investigations led to malignancy in 13. We believe that EBUS-FNA represents a good alternative to more invasive diagnostic procedures when conventional methods fail, even though the diagnostic yield is lower compared with mediastinal staging in patients with known lung cancer. In almost half of the cases, EBUS-FNA provides the final diagnosis without exposing the patient to the risk of complications from more invasive procedures.

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in an Unselected Cohort

“…23 However, there are a lot of such patient groups who all meet the indications for EBUS-TBNA and we see all of them in our daily work. We found it interesting to examine the procedure in an unselected cohort of patients meeting the indications for EBUS-TBNA.…”

Endobronchial ultrasound‐guided transbronchial needle aspiration cytology: a state of the art review

“…A recent study showed that in such cases EBUS-TBNA can provide a diagnosis of malignancy in 77% of patients who had undergone a previous non-diagnostic flexible bronchoscopy. 82 Mediastinal lymphadenopathy in patients suspected of sarcoidosis. While most EBUS-TBNA procedures were performed on mediastinal or central lung lesions, sampling of peripheral lung lesions is also possible by the use of radial EBUS followed by TBNA 81 or with linear, real-time EBUS.…”

The diagnostic efficacy of combining bronchoscopic tissue biopsy and endobronchial ultrasound‐guided transbronchial needle aspiration for the diagnosis of malignant lesions in the lung

“…EBUS‐TBNA has particular advantages over forceps biopsy in that it can be used to sample lesions which are not located immediately adjacent to the airway, such as mediastinal lymph nodes, and can be precisely aimed at a lesion which is visualized on endoscopic ultrasound. A recent study by Eckardt et al, showed EBUS‐TBNA to be a valid alternative when other minimally invasive techniques fail to provide a diagnosis, rather than pursuing more invasive procedures as a next step …”