Endoscopic Ultrasound-Guided Liver Biopsy in the Hands of a Chest Physician

Abstract

Liver biopsy using transesophageal bronchoscopic ultrasound-guided fine needle aspiration (EUS-B-FNA) has never been described before and biopsies of infradiaphragmatic lesions using this technique are not considered to be standard. A patient suspected for primary lung cancer with multiple lesions in the liver was referred to our department. We conducted bronchoscopy and endobronchial ultrasound-guided (EBUS) biopsy from several enlarged mediastinal lymph nodes. Thereafter, we conducted EUS-B-FNA from a lesion in the left liver lobe. Pathology showed that the liver lesion represented a metastasis from a pulmonary adenocarcinoma. Bronchoscopy and EBUS samples were not able to establish diagnosis. We hereby demonstrated that a diagnostic EUS-B-FNA from a liver metastasis in a patient with lung cancer is possible. This underlines that chest physicians should not forget the esophagus when staging lung cancer.

Added value of EUS-B-FNA to bronchoscopy and EBUS-TBNA in diagnosing and staging of lung cancer

“…Liver metastases at the time of lung cancer diagnosis affects 5% of patients with NSCLC, and 25% of patients with SCLC [ 41 , 42 ]. The first EUS-B-FNA from a liver metastasis was described in 2015 [ 43 ] and was followed by larger series [ 44 ]. EUS-B gives access to lesions in the left liver lobe ( Figure 8 ).…”

Endosonography of the mediastinum - access by the echobronchoscope through the esophagus (EUSB)

“…">ВведениеКак уже отмечалось ранее, исторически первоначальным доступом к средостению для эндосонографии был именно чреспищеводный с помощью эхогастроскопов. Вместе с тем, почти сразу же после начала широкого применения эндобронхиальной ультрасонографии, стали описываться единичные случаи применения эхобронхоскопа с помощью трансэзофагеального доступа [3][4]. Такое исследование получило аббревиатуру ЭУС-б (где литера «б» означает применение эхобронхоскопа).…”