Endoscopic ultrasound-guided fine needle aspiration in the evaluation of suspected lung cancer

Summary Background and aim The role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis and staging of lung cancer is still not fully explored. This prospective study aimed to define the effectiveness of EUS-FNA as an adjunct to computer tomography (CT) and bronchoscopy...

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Published in:	Respiratory medicine Vol. 101; no. 6; pp. 1299 - 1304
Main Authors:	Ang, T.L, Tee, A.K.H, Fock, K.M, Teo, E.K, Chua, T.S
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier Ltd 01-06-2007 Elsevier Elsevier Limited
Subjects:	Abdomen Adrenal glands Aged Aged, 80 and over Biological and medical sciences Biopsy, Fine-Needle - methods Bronchoscopy - methods Carcinoma, Non-Small-Cell Lung - diagnosis Carcinoma, Non-Small-Cell Lung - secondary Clinical medicine EUS-FNA Female Humans Lung cancer Lung Neoplasms - diagnosis Lung Neoplasms - diagnostic imaging Lung Neoplasms - pathology Lymphatic Metastasis Male Mediastinal lymph nodes Mediastinum Medical sciences Middle Aged Neoplasm Staging Onsite Pneumology Prospective Studies Pulmonary/Respiratory Statistical analysis Tomography Tomography, X-Ray Computed Tumors of the respiratory system and mediastinum Ultrasonography, Interventional - methods Japan Lung cancer EUS-FNA Mediastinal lymph nodes Sonography Lung disease Evaluation Lymph node Endoscopic route Respiratory disease Mediastinum Endoscopic ultrasonography Malignant tumor Aspiration punction Guidance Fine needle Echography Bronchus disease Endoscopy Ultrasound Pneumology
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Summary:	Summary Background and aim The role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis and staging of lung cancer is still not fully explored. This prospective study aimed to define the effectiveness of EUS-FNA as an adjunct to computer tomography (CT) and bronchoscopy in the evaluation of suspected lung cancer in routine clinical practice. Methods Over a period of 20 weeks, the data of 16 consecutive patients suspected of lung cancer on account of respiratory symptoms, and/or the findings of either a mass or mediastinal lymph nodes on helical CT, who were referred for evaluation by EUS, were prospectively collected. Fourteen of these patients underwent sequential bronchoscopy followed by EUS-FNA in the same setting. Results Bronchoscopy was performed in 15 patients, while EUS was performed in all 16 patients. Bronchoscopy diagnosed 9 cases of non-small-cell lung cancer (NSCLC) but was falsely negative in 3 cases of malignancies, which were all established by EUS-FNA of mediastinal lymph nodes (2 cases of NSCLC and 1 case of esophageal squamous cell cancer). EUS-FNA also diagnosed advanced NSCLC in another patient who did not undergo bronchoscopy, such that eventually 13 patients were diagnosed to have malignancies. Distant metastases were diagnosed by EUS-FNA in 4 cases of NSCLC (2 cases of left adrenal gland and 2 cases of pancreatic metastases). Two patients were diagnosed to have sarcoidosis and 1 patient was diagnosed to have pneumoconiosis eventually. Conclusions EUS-FNA is useful as an adjunct to CT and bronchoscopy in the evaluation of suspected lung cancer.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0954-6111 1532-3064
DOI:	10.1016/j.rmed.2006.10.013