Preliminary experience with a new method of endoscopic transbronchial real time ultrasound guided biopsy for diagnosis of mediastinal and hilar lesions

• Published in: Thorax Vol. 58; no. 12; pp. 1083 - 1086
• Main Authors: Krasnik, M, Vilmann, P, Larsen, S S, Jacobsen, G K
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Thoracic Society 01.12.2003; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biopsy; Biopsy, Needle - methods; Cardiology. Vascular system; Cellular biology; Chemotherapy; diagnosis; EBUS-FNA; endoscopic transbronchial ultrasonography with fine needle aspiration biopsy; endoscopic transbronchial ultrasound guided biopsy; endoscopic ultrasonography; endoscopic ultrasonography with fine needle aspiration biopsy; Endoscopy; Endosonography - methods; EUS-FNA; Female; fine needle aspiration; Humans; Lung Cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis - diagnostic imaging; Lymphatic Metastasis - pathology; Lymphatic system; Male; Mediastinal Neoplasms - diagnostic imaging; Mediastinal Neoplasms - secondary; Medical imaging; Medical sciences; Metastasis; Middle Aged; non-small cell lung cancer; NSCLC; Ostomy; Patients; PET; Pneumology; positron emission tomography; Real time; SCLC; small cell lung cancer; Ultrasonic imaging; Ultrasonography, Interventional - methods; Sonography; Mediastinum; Method; Real time; Guidance; Biopsy; Anesthesia; Circulatory system; Diagnosis; Endoscopy; Lesion; Technique; Cardiology; Ultrasound
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax.58.12.1083

Background: The aim of the present study was to gain experience with a new method of endoscopic transbronchial ultrasonography with direct, real time guided fine needle aspiration biopsy (EBUS-FNA). Methods: EBUS-FNA was performed in 11 patients. Selection of the patients for EBUS-FNA was based on computed tomographic (CT) scanning in 10 patients and on positron emission tomography in one. The ultrasonic bronchoscope used was a prototype with an outer diameter of 6.9 mm. The instrument has a small curved array transducer located in front of a 30° oblique forward viewing optic lens and a biopsy channel of 2 mm. The procedures were performed under general anaesthesia. EBUS-FNA was performed by direct transducer contact with the trachea or main bronchi with a prototype 22 gauge needle. Results: A total of 15 lesions were punctured. No complications were experienced. Four lesions were targeted in region 10L, four in region 10R, one in region 4L, three in region 4R, one in region 1, one in region 7, and one in region 2R. The size of the lesions ranged from 7 mm to 80 mm. EBUS-FNA identified malignant cells in 13 lesions and benign cells in two. Conclusions: EBUS-FNA is a promising technique for lymph node staging of lung cancer as well as for the primary diagnosis of solid lesions located adjacent to the trachea and main bronchi and not accessible by other methods apart from surgical intervention.