| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
LUNG CANCER |
1 Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Germany
2 Department of Surgical Gastroenterology, Gentofte University Hospital, Copenhagen, Denmark
3 Department of Cardiothoracic Surgery, Gentofte University Hospital, Copenhagen, Denmark
4 Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
Correspondence to:
Correspondence to:
Professor F J F Herth
Department of Internal Medicine, Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Amalienstr 5, D-69126 Heidelberg, Germany; Felix.Herth{at}thoraxklinik-heidelberg.de
Background: Transbronchial needle aspiration (TBNA) is an established method for sampling mediastinal lymph nodes to aid in diagnosing lymphadenopathy and in staging lung cancers. Real-time endobronchial ultrasound (EBUS) guidance is a new method of TBNA that may increase the ability to sample these nodes and hence to determine a diagnosis. A descriptive study was conducted to test this new method.
Methods: Consecutive patients referred for TBNA of mediastinal lymph nodes were included in the trial. When a node was detected, a puncture was performed under real-time ultrasound control. The primary end point was the number of successful biopsy specimens. Diagnostic results from the biopsies were compared with operative findings. Lymph node stations were classified according to the recently adopted American Thoracic Society scheme.
Results: From 502 patients (316 men) of mean age 59 years (range 24–82), 572 lymph nodes were punctured and 535 (94%) resulted in a diagnosis. Biopsy specimens were taken from lymph nodes in region 2L (40 nodes), 2R (53 nodes), 3 (35 nodes), 4R (86 nodes), 4L (77 nodes), 7 (127 nodes), 10R (38 nodes), 10L (43 nodes), 11R (40 nodes) and 11L (33 nodes). The mean (SD) diameter of the nodes was 1.6 (0.36) cm and the range was 0.8–3.2 cm (SD range 0.8–4.3). Sensitivity was 94%, specificity 100%, and the positive predictive value was 100% calculated per patient. No complications occurred.
Conclusion: EBUS-TBNA is a promising new method for sampling mediastinal lymph nodes. It appears to permit more and smaller nodes to be sampled than conventional TBNA, and it is safe.
Abbreviations: EBUS, endobronchial ultrasound; NSCLC, non-small cell lung cancer; TBNA, transbronchial needle aspiration
Keywords: lung cancer; transbronchial needle aspiration; endobronchial ultrasound; mediastinal lymphadenopathy
This article has been cited by other articles:
|
|
 |
|
  M E J Callister, A Gill, W Allott, and P K Plant Endobronchial ultrasound guided transbronchial needle aspiration of mediastinal lymph nodes for lung cancer staging: a projected cost analysis Thorax, April 1, 2008; 63(4): 384 - 384. [Full Text] [PDF]
|
|
|
|
 |
|
 F. J. F. Herth, R. Eberhardt, M. Krasnik, and A. Ernst Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Lymph Nodes in the Radiologically and Positron Emission Tomography-Normal Mediastinum in Patients With Lung Cancer Chest, April 1, 2008; 133(4): 887 - 891. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M P Kennedy, C A Jimenez, J F Bruzzi, A D Mhatre, X Lei, F J Giles, T Fanning, R C Morice, and G A Eapen Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lymphoma Thorax, April 1, 2008; 63(4): 360 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G A Silvestri and S G Spiro Carcinoma of the bronchus 60 years later Postgrad. Med. J., April 1, 2008; 84(990): 182 - 187. [Full Text] [PDF]
|
|
|
|
 |
|
 K. G. Tournoy, F. De Ryck, L. R. Vanwalleghem, F. Vermassen, M. Praet, J. G. Aerts, G. Van Maele, and J. P. van Meerbeeck Endoscopic Ultrasound Reduces Surgical Mediastinal Staging in Lung Cancer: A Randomized Trial Am. J. Respir. Crit. Care Med., March 1, 2008; 177(5): 531 - 535. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. B. Wallace, J. M. S. Pascual, M. Raimondo, T. A. Woodward, B. L. McComb, J. E. Crook, M. M. Johnson, M. A. Al-Haddad, S. A. Gross, S. Pungpapong, et al. Minimally Invasive Endoscopic Staging of Suspected Lung Cancer JAMA, February 6, 2008; 299(5): 540 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Vincent, E. El-Bayoumi, B. Hoffman, P. Doelken, J. DeRosimo, C. Reed, and G. A. Silvestri Real-Time Endobronchial Ultrasound-Guided Transbronchial Lymph Node Aspiration Ann. Thorac. Surg., January 1, 2008; 85(1): 224 - 230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Nakajima, K. Yasufuku, A. Iyoda, S. Yoshida, M. Suzuki, Y. Sekine, K. Shibuya, K. Hiroshima, Y. Nakatani, and T. Fujisawa The evaluation of lymph node metastasis by endobronchial ultrasound-guided transbronchial needle aspiration: Crucial for selection of surgical candidates with metastatic lung tumors. J. Thorac. Cardiovasc. Surg., December 1, 2007; 134(6): 1485 - 1490. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Garwood, M. A. Judson, G. Silvestri, R. Hoda, M. Fraig, and P. Doelken Endobronchial Ultrasound for the Diagnosis of Pulmonary Sarcoidosis Chest, October 1, 2007; 132(4): 1298 - 1304. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Tino Clinical Year in Review I: Lung Cancer, Interventional Pulmonology, Pediatric Pulmonary Disease, and Pulmonary Vascular Disease Proceedings of the ATS, September 15, 2007; 4(6): 478 - 481. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Nakajima, K. Yasufuku, K. Shibuya, and T. Fujisawa Endobronchial ultrasound-guided transbronchial needle aspiration for the treatment of central airway stenosis caused by a mediastinal cyst Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 538 - 540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. C. Detterbeck, M. A. Jantz, M. Wallace, J. Vansteenkiste, and G. A. Silvestri Invasive Mediastinal Staging of Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 202S - 220S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. C Detterbeck Evolution and science, progress and change Thorax, August 1, 2007; 62(8): 654 - 655. [Full Text] [PDF]
|
|
|
|
|
|
T. Nakajima, K. Yasufuku, M. Suzuki, K. Hiroshima, R. Kubo, S. Mohammed, Y. Miyagi, S. Matsukuma, Y. Sekine, and T. Fujisawa Assessment of Epidermal Growth Factor Receptor Mutation by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Chest, August 1, 2007; 132(2): 597 - 602. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Silvestri Boys (and Girls) and Their Toys: A Look at New Technologies in the Bronchoscopy Suite Am. J. Respir. Crit. Care Med., July 1, 2007; 176(1): 1 - 2. [Full Text] [PDF]
|
|
|
|
|
|
A. H.M. Piet, F. J. Lagerwaard, P. W.A. Kunst, J. R. van Sornsen de Koste, B. J. Slotman, and S. Senan Can Mediastinal Nodal Mobility Explain the Low Yield Rates for Transbronchial Needle Aspiration Without Real-Time Imaging? Chest, June 1, 2007; 131(6): 1783 - 1787. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. J. F. Herth, K. F. Rabe, S. Gasparini, and J. T. Annema Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions Eur. Respir. J., December 1, 2006; 28(6): 1264 - 1275. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G A Silvestri and S G Spiro Carcinoma of the bronchus 60 years later. Thorax, December 1, 2006; 61(12): 1023 - 1028. [Full Text] [PDF]
|
|
|
|
|
|
P. N. Chhajed and M. Tamm Bronchoscopy for small pulmonary nodules and mediastinal staging of lung cancer: just do it! Am. J. Respir. Crit. Care Med., November 1, 2006; 174(9): 961 - 962. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
