Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of hilar and mediastinal lymph node metastases of melanoma

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.

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Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Mediastinal Lymph Node Staging in Non-Small Cell Lung Cancer

Seminars in Thoracic and Cardiovascular Surgery ◽

10.1053/j.semtcvs.2008.11.004 ◽

2008 ◽

Vol 20 (4) ◽

pp. 274-278 ◽

Cited By ~ 9

Author(s):

Shawn S. Groth ◽

Rafael S. Andrade

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Mediastinal Lymph Node ◽

Needle Aspiration ◽

Small Cell ◽

Endobronchial Ultrasound ◽

Lymph Node Staging ◽

Small Cell Lung ◽

Ultrasound Guided ◽

Transbronchial Needle Aspiration

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#EBUSTwitter: Novel Use of Social Media for Conception, Coordination, and Completion of an International, Multicenter Pathology Study

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2019-0297-oa ◽

2019 ◽

Vol 144 (7) ◽

pp. 878-882 ◽

Cited By ~ 2

Author(s):

Marcos Lepe ◽

Pembe Oltulu ◽

Mariana Canepa ◽

Roseann I. Wu ◽

Amy Deeken ◽

...

Keyword(s):

Social Media ◽

Lymph Node ◽

Mediastinal Lymph Node ◽

Needle Aspiration ◽

Endobronchial Ultrasound ◽

Ultrasound Guided ◽

Transbronchial Needle Aspiration ◽

Social Media Platform ◽

Biopsy Site ◽

Media Platform

Context.— Social media sites are increasingly used for education, networking, and rapid dissemination of medical information, but their utility for facilitating research has remained largely untapped. Objective.— To describe in detail our experience using a social media platform (Twitter) for the successful initiation, coordination, and completion of an international, multi-institution pathology research study. Design.— Following a tweet describing a hitherto-unreported biopsy-related histologic finding in a mediastinal lymph node following endobronchial ultrasound–guided transbronchial needle aspiration, a tweet was posted to invite pathologists to participate in a validation study. Twitter's direct messaging feature was used to create a group to facilitate communication among participating pathologists. Contributing pathologists reviewed consecutive cases of mediastinal lymph node resection following endobronchial ultrasound–guided transbronchial needle aspiration and examined them specifically for biopsy site changes. Data spreadsheets containing deidentified data and digital photomicrographs of suspected biopsy site changes were submitted via an online file hosting service for central review by 5 pathologists from different institutions. Results.— A total of 24 pathologists from 14 institutions in 5 countries participated in the study within 143 days of study conception, and a total of 297 cases were collected and analyzed. The time interval between study conception and acceptance of the manuscript for publication was 346 days. Conclusions.— To our knowledge, this is the first time that a social media platform has been used to generate a research idea based on a tweet, recruit coinvestigators publicly, communicate with collaborating pathologists, and successfully complete a pathology study.

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Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132015000004466 ◽

2015 ◽

Vol 41 (3) ◽

pp. 219-224 ◽

Cited By ~ 5

Author(s):

Sebastián Fernández-Bussy ◽

Gonzalo Labarca ◽

Sofia Canals ◽

Iván Caviedes ◽

Erik Folch ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Diagnostic Yield ◽

Mediastinal Lymph Node ◽

Needle Aspiration ◽

Endobronchial Ultrasound ◽

Lymph Node Staging ◽

Ultrasound Guided ◽

Transbronchial Needle Aspiration ◽

The Mean

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.

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Mediastinal lymph node staging by EBUS-TBNA and CT: Characteristics of lymph node enlargement caused by anthracosis and other benign conditions

International Journal of Diagnostic Imaging ◽

10.5430/ijdi.v1n2p64 ◽

2014 ◽

Vol 1 (2) ◽

pp. 64

Author(s):

Johannes Kirchner ◽

Michael Broll ◽

Philipp Müller ◽

Esther Maria Kirchner ◽

Natalia Pomjanski ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Mediastinal Lymph Node ◽

Needle Aspiration ◽

Endobronchial Ultrasound ◽

Control Group ◽

Lymph Node Staging ◽

Ultrasound Guided ◽

Transbronchial Needle Aspiration ◽

Lymph Node Enlargement

Objectives: Aim of this comparative study was to assess the accuracy of computed tomography (CT) and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging in cases of lymph node enlargement due to anthracosis and other benign conditions. Methods: In a retrospective analysis we report on the MSCT findings of 39 patients (28 males, 11 females) with EBUS-TBNA confirmed diagnosis of 53 enlarged lymph nodes due to anthracosis. A control group comprised 20 consecutive patients with 27 enlarged lymph nodes (11 males, 9 females) due to chronic lymphadenopathy (n = 14) or sarcoidosis (n = 13). Results: No significant differences were observed between the two groups regarding size (mean short axis diameter 13.7mm vs. 14.5mm), shape (most often oval) or presence of lymph node confluence (32.1% vs. 33.3%), contrast enhancement (3.8% vs. 3.7%), and fatty involution (3.8% vs. 3.7%). In comparison with the control group anthracotic lymph nodes were significantly less often ill-defined in EBUS (5.7 vs. 25.9, p = 0.025) as well as in CT (1.9% vs. 18.5%, p = 0.01), but more often showed calcifications in CT (24.5% vs. 3.7%, p = 0.017). Lymph node colliquation was seen neither in anthracosis nor in other benign conditions. Conclusions: Mediastinal lymph node enlargement due to anthracosis, lymphadenopathy and sarcoidosis show some different findings in EBUS and CT but cannot definitely be differentiated. Advances in knowledge: Radiologists should be aware of mediastinal lymph node enlargement due to anthracosis.

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The Techniques of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e31820c91a7 ◽

2011 ◽

Vol 6 (1) ◽

pp. 57-64 ◽

Cited By ~ 11

Author(s):

Takahiro Nakajima ◽

Kazuhiro Yasufuku

Keyword(s):

Lymph Node ◽

Diagnostic Yield ◽

Mediastinal Lymph Node ◽

Needle Aspiration ◽

Endobronchial Ultrasound ◽

Lymph Node Staging ◽

Ultrasound Guided ◽

Surgical Biopsy ◽

Transbronchial Needle Aspiration ◽

High Diagnostic Yield

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality for mediastinal lymph node staging in lung cancer patients as well as for the diagnosis of mediastinal and hilar adenopathy. The high diagnostic yield of EBUS-TBNA for lymph node staging has been shown in systematic reviews and meta-analysis. It has attracted physicians and surgeons as an alternative modality to surgical biopsy for the assessment of patients with enlarged mediastinal and/or hilar lymph nodes. Cell blocks obtained by EBUS-TBNA can be applicable not only for pathologic diagnosis but also for further investigations such as immunohistochemistry and fluorescence in situ hybridization. In addition, samples obtained by EBUS-TBNA can also be used for molecular analysis. Unlike regular bronchoscopy, EBUS-TBNA uses the convex probe EBUS with an ultrasound probe on the tip of a flexible bronchoscope. It is important for the bronchoscopist to fully understand the mediastinal anatomy and be able to correlate it with the ultrasound images for a successful EBUS-TBNA. The dedicated transbronchial needle used for EBUS-TBNA is somewhat different from an ordinary transbronchial biopsy forceps. Training is mandatory for achieving high diagnostic yield without complications. The learning curve of EBUS-TBNA is different from each physician, and continuous training program will be needed for impartiality. This article explains the detailed techniques of EBUS-TBNA to master this innovative procedure.

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