EUS-guided FNA of lung masses adjacent to or abutting the esophagus after unrevealing CT-guided biopsy or bronchoscopy
Section snippets
Patients and Methods
The records of all patients who underwent EUS-FNA of lung parenchymal lesions from July 2000 to June 2003 were reviewed retrospectively. Patients were referred for mediastinal EUS-FNA staging of suspected lung cancer after failure by CT-guided sampling and/or bronchoscopy to establish a tissue diagnosis. Patients were referred by thoracic surgeon members of a multidisciplinary team who were highly familiar with the application of EUS in lung cancer staging. These surgeons prefer to stage lung
Observations
Eighteen patients (11 men, 7 women; mean age 62.5 years; range 41–77 years) underwent EUS because CT revealed a lung mass (Table 1). In all patients, prior attempts to establish a definitive tissue diagnosis by CT-guided tissue sampling and/or bronchoscopy had been unsuccessful (CT, 9 patients; bronchoscopy, 6; both, 3). Fourteen patients had a right- or a left-side lower lobe lung mass, and 4 had a right- or a left-side upper lobe lung mass.
Radial and linear echoendoscopy was performed in all
Discussion
This series demonstrates the feasibility of estab-lishing a tissue diagnosis by EUS-FNA in patients with lung parenchymal masses adjacent to or abutting the esophagus. In a series of 49 patients with mediastinal masses from a single center, a diagnosis of lung cancer was made by EUS-FNA in 4 patients, all of whom had previously undiagnosed lung cancer.6 There was no procedure-related complication. As an initial approach to the diagnosis of lung cancer, lung tissue usually is obtained under CT
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