scholarly journals Value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of lung and mediastinal lesions

2020 ◽  
Vol 66 (9) ◽  
pp. 1210-1216
Author(s):  
Augusto Carbonari ◽  
Lucio Rossini ◽  
Fabio Marioni ◽  
Marco Camunha ◽  
Mauro Saieg ◽  
...  

SUMMARY OBJECTIVE: To evaluate the value of EBUS-TBNA in the diagnosis of lung and mediastinal lesions. METHODS: Prospective cohort study that included 52 patients during a 2-year period (2016 to 2018) who underwent EBUS-TBNA. RESULTS: Among the 52 individuals submitted to the procedure, 22 (42.31%) patients were diagnosed with locally advanced lung cancer (N2 or N3 lymph node involvement). EBUS-TBNA confirmed the diagnosis of metastases from other extrathoracic tumors in the mediastinum or lung in 5 patients (9.61%), confirmed small cell lung cancer in 3 patients (5.76%), mediastinal sarcoidosis in 1 patient (1.92%), and reactive mediastinal lymph node in 8 patients (15.38%); insufficient results were found for 3 patients (5.76%). Based on these results, EBUS-TBNA avoided further subsequent surgical procedures in 39 of 52 patients (75%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 86%, 100%, 100%, 77%, and 90%, respectively. No major complications were observed. CONCLUSIONS: EBUS-TBNA is a safe, effective, and valuable method. This technique can significantly reduce the rate of subsequent surgical procedures required for the diagnosis of lung and mediastinal lesions.

2015 ◽  
Vol 41 (3) ◽  
pp. 219-224 ◽  
Author(s):  
Sebastián Fernández-Bussy ◽  
Gonzalo Labarca ◽  
Sofia Canals ◽  
Iván Caviedes ◽  
Erik Folch ◽  
...  

OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer. METHODS: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method). RESULTS: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma. CONCLUSIONS: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17503-e17503
Author(s):  
Miriam Mendez ◽  
Constanza Maximiano ◽  
Miriam Huelves ◽  
Bernard Gaston Doger de Speville ◽  
Patricia Ibeas ◽  
...  

e17503 Background: Lung cancer is the leading cause of cancer-related deaths in the Western world. CT and mediastinoscopy are the standard for staging modalities in recent years; PET has emerged as a complement to other techniques. Mediastinal lymph node (MLN) staging is important because it establishes subsequent treatment. The aim of the present study is to analyze the relationship between mediastinal staging by endobronchial ultrasound-guided transbronchial needle aspiration, mediastinoscopy, lymphadenectomy and PET. It also analyzes the patient characteristics like age, sex, histology. Methods: The study prospectively evaluated 42 patients from August 2009 to March 2011. All of them had MLN staging by PET and pathology (tumor resection with systematic lymph node dissection, transbronchial needle aspiration or mediastinoscopy). Univariable date analysis was conducted using Pearson's chi-square test. P values were considered statistically significant if <0.05. Results: The study group comprised 42 patients, 83% men and 17% female, mean age of 66 years. The primary tumor cell type: 45% squamous cell, 33% adenocarcinoma and 19% large cells. 40 patients were smoking. The most frequent location of tumor was upper lobes (58%). The most common stage found after surgery was stage I (42%), stage II (19%), stage III (A: 29%, B: 5%) and stage IV (5%). The kappa statistic for diagnostic agreement between CT and PET was 0.53 (p<0.001). About MLN staging, PET has a sensitivity of 61% and specificity of 53% , positive predictive value 61% and negative 53%. Conclusions: The present study attempts to find the relationship between tumor involvement found in PET and resected tumor specimens obtained from the mediastinum. Our sensitivity and specificity were not concordant with those previously reported; this may be due to the learning curve at our center or the shortness of our series. In contrast we conducted histological examination of all involved MLNs, supporting our data and shows that this confirmation can lead to a change of therapeutic strategy in some cases.


2018 ◽  
Vol 16 (3) ◽  
pp. 351-353
Author(s):  
Ashesh Dhungana ◽  
Prajowl Shrestha ◽  
Kiran Shrestha ◽  
Shristi Shah ◽  
Pratikchya Karki ◽  
...  

Evaluation of mediastinal lymphadenopathy is often challenging. Endobronchial Ultrasound (EBUS) is a novel technique which provides real time sonographic guidance during Transbronchial Needle Aspiration (TBNA) from mediastinal and hilar lesions. A 60-year-old smoker presented with two months history of cough and chest pain on the right side. CT thorax revealed a right upper lobe spiculated mass with paratracheal (Station 4R) and subcarinal (Station 7) lymph nodes. Bronchoscopy did not reveal any endobronchial mass. Since EBUS-TBNA is superior to conventional TBNA for malignant mediastinal node, an EBUS- TBNA was performed from both lymph node stations. . Cytopathology and histopathology revealed non-small cell lung cancer. We hereby report the first use of EBUS-TBNA in Nepal, in a patient with lung cancer and mediastinal lymphadenopathy.Keywords: Endobronchial ultrasound; lung cancer; mediastinal lymph node; transbronchial needle aspiration.


2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Shingo Nishikawa ◽  
Ryo Ariyasu ◽  
Tomoaki Sonoda ◽  
Masafumi Saiki ◽  
Takahiro Yoshizawa ◽  
...  

A 27-year-old man was diagnosed with inflammatory myofibroblastic tumor, and multiple lymph node and subcutaneous metastases. After several administrations of anti-tumor therapy, he underwent mediastinal lymph node biopsy using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to confirm tumor relapse. Five weeks later, he complained of chest pain, then rapidly developed shock due to acute pericarditis. Although he was treated with antibiotics for anaerobic bacterial infection and cardiac drainage, mediastinal lymph node abscess and pericarditis did not improve. After the surgical procedure, his physical condition dramatically improved and he was treated with another molecularly targeted therapy. Pericarditis associated with EBUS-TBNA is extremely rare. In this case, salvage was achieved by surgical drainage of the lymph node abscess and pericarditis, and long survival was obtained with further administration of anti-tumor treatment.


2015 ◽  
Vol 41 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Viviane Rossi Figueiredo ◽  
Paulo Francisco Guerreiro Cardoso ◽  
Márcia Jacomelli ◽  
Sérgio Eduardo Demarzo ◽  
Addy Lidvina Mejia Palomino ◽  
...  

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil. Methods: This was a retrospective analysis of patients diagnosed with lung cancer and submitted to EBUS-TBNA for mediastinal lymph node staging. The EBUS-TBNA procedures, which involved the use of an EBUS scope, an ultrasound processor, and a compatible, disposable 22 G needle, were performed while the patients were under general anesthesia. Results: Between January of 2011 and January of 2014, 149 patients underwent EBUS-TBNA for lymph node staging. The mean age was 66 ± 12 years, and 58% were male. A total of 407 lymph nodes were sampled by EBUS-TBNA. The most common types of lung neoplasm were adenocarcinoma (in 67%) and squamous cell carcinoma (in 24%). For lung cancer staging, EBUS-TBNA was found to have a sensitivity of 96%, a specificity of 100%, and a negative predictive value of 85%. Conclusions: We found EBUS-TBNA to be a safe and accurate method for lymph node staging in lung cancer patients.


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