The Utility of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in Patients with Small-cell Lung Cancer

Abstract

Objective Most small-cell lung cancers (SCLCs) are located within the central aspect of the chest and manifest as a mediastinal or hilar lymphadenopathy. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) makes it possible to perform mediastinal and hilar nodal examinations. The purpose of this study was to evaluate the performance of EBUS-TBNA in the diagnosis of SCLC. Methods The diagnostic performances of EBUS-TBNA and/or transesophageal bronchoscopic ultrasoundguided fine-needle aspiration (EUS-FNA-B/E) were calculated using the standard definitions. Patients The study consisted of a retrospective review of the medical records for all patients with histologically proven SCLC who previously underwent EBUS-TBNA and/or EUS-FNA-B/E from May 2009 to September 2014. Results The analysis was based on 161 patients and 299 aspirated specimens. The patient group included 144 males (89%); the median age was 66 years. EBUS-TBNA and/or EUS-FNA-B/E were performed in 239 mediastinal nodes, 39 hilar/interlobar nodes, and 21 lung parenchymal lesions. The median short diameter of the biopsied lesions was 17 mm. The overall sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of EBUS-TBNA and/or EUS-FNA-B/E on a per-person basis were 97.4%, 100%, 60%, 100%, and 97.5%, respectively. The corresponding values on a per-lesion basis were 91.8%, 100%, 73.0%, 100%, and 93.3%, respectively. There were no serious complications related to EBUS-TBNA. Conclusion In our series of patients with SCLC, EBUS-TBNA had an excellent diagnostic yield in the evaluation of mediastinal, hilar and lung parenchymal lesions. Thus, EBUS-TBNA could be a useful and safe diagnostic method with which to evaluate patients with SCLC.

Utility of endobronchial ultrasound‐guided transbronchial needle aspiration in diagnosing non‐specific inflammatory intrathorcacic lymphadenitis

“…1,2 Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a useful technique for evaluating medaistinal/hilar lymphadenopathy since invented, including diagnosing and staging of lung cancer, diagnosis of mediastinal malignancies as well as some specific benign diseases, such as sarcoidosis and tuberculosis (TB), because it is a minimally invasive procedure that is generally available, easy to use and with minimal additional costs. [3][4][5][6][7][8][9] Less is known, however, about the utility of EBUS-TBNA for diagnosing non-specific intrathoracic inflammatory lymphadenopathy.…”

Minimally Invasive Approach to Esophageal Perforation after Endoscopic Ultrasound-Guided Fine-Needle Aspiration: A Report of 2 Cases

“…In particular, differentiating between inflammatory processes and malignancy is especially difficult and a pathological diagnosis is generally required. The overall sensitivity and specificity of EUS-FNA and/or endobronchial ultrasound (EBUS)-transbronchial needle aspiration were reported to be 97.4% and 100%, respectively [1]. Although severe complications are rare, we report 2 serious and life-threatening cases of esophageal wall rupture after EUS-FNA.…”

Accuracy of nodal staging by 18F-FDG-PET/CT in limited disease small-cell lung cancer

“…The specificity may be too low to indicate usage of FDG-PET/CT alone as the staging method of SCLC compared to studies evaluating EBUS-TBNA indicating a higher specificity. 14 , 15 A recent study evaluated the benefits of increased incorporation of EBUS and PET/CT and indicated a more precise stratification. 16 The data suggest that FDG-PET/CT alone could not match up to that gain of stratification.…”