Chest
Clinical InvestigationsLUNG CANCERReal-time Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Mediastinal and Hilar Lymph Nodes
Section snippets
Patients
Between March 2002 and September 2003, 70 patients having mediastinal and/or hilar lymphadenopathy of > 1 cm and with known or suspected malignancy were included in the study. A chest radiograph and CT scan of the chest (plain and contrast- enhanced) were performed in all patients.
Written informed consent was obtained from all the patients included in the study. Conventional flexible bronchoscopy (model BF-240 bronchoscope; Olympus; Tokyo, Japan) was first performed in a standard fashion to
Results
Seventy patients underwent CP-EBUS (52 men and 18 women; mean age, 64.3 years; SD, 10.4 years; range, 37 to 86 years). All lymph nodes that were detected on the chest CT scan could be visualized using CP-EBUS. Direct real-time CP-EBUS-guided TBNA was performed in all 70 patients to obtain samples from mediastinal lymph nodes (58 nodes) and hilar lymph nodes (12 nodes). The procedure was uneventful, and there were no complications.
Figures 2 and 3show the CT scan appearance of the lymph nodes,
Discussion
Present investigation methods in radiology such as CT and US have resulted in a decrease in the number of mediastinoscopies performed.11 The limitations, complications, or morbidity associated with thoracoscopy,12 CT scan-guided percutaneous needle aspiration of mediastinal lymph nodes,5 and conventional TBNA2 have led some institutions to use transesophageal fine-needle aspiration to sample mediastinal lymph nodes. The need for direct EBUS-guided TBNA has been expressed previously.6,7,13 The
ACKNOWLEDGMENT
The authors thank Kenichi Nishina and Yusuke Ichikawa (Olympus Optical Corporation) for technical assistance.
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