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Endoscopic ultrasound‐guided fine needle aspiration is useful for nodal staging in patients with pleural mesothelioma
Author(s) -
Bean Sarah M.,
Eloubeidi Mohamad A.,
Cerfolio Robert,
Chhieng David C.,
Eltoum Isam A.
Publication year - 2008
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.20740
Subject(s) - medicine , contraindication , lymph node , radiology , mesothelioma , fine needle aspiration , stage (stratigraphy) , lymph , lung cancer staging , extrapleural pneumonectomy , endoscopic ultrasound , pneumonectomy , surgery , lung , mediastinoscopy , biopsy , pathology , paleontology , alternative medicine , biology
Abstract Patients with malignant pleural mesothelioma and negative N2 stage lymph nodes may benefit from extrapleural pneumonectomy with adjuvant therapy. The objective of this study is to describe the use of EUS‐FNA to determine N2 stage status in patients with mesothelioma and its impact in the management of such patients. Six patients (mean age, 62 yr; median age, 63 yr; range, 52–70 yr; 5 men; 1 woman) underwent EUS‐FNA for staging of N2 lymph nodes from July 2000 to July 2006. Follow‐up included operative notes, treatment summaries, and surgical pathology. Eight sites were aspirated: four subcarinal lymph nodes, three aorto‐pulmonary window lymph nodes, and one paraesophageal mass. Two of 8 (25%) aspirates were positive for metastatic disease in two different patients. Two false negative EUS‐FNAs were observed and were attributed to sampling error not diagnostic error. No complications were observed. EUS‐FNA is a safe N2 node staging technique in patients with mesothelioma. A positive N2 lymph node by EUS‐FNA may be a contraindication to definitive surgery in patients with malignant mesothelioma. Diagn. Cytopathol. 2008;36:32–37. © 2007 Wiley‐Liss, Inc.