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The role of endobronchial ultrasound‐guided fine needle aspiration in the diagnosis of pleural mesothelioma
Author(s) -
Ghigna M. R.,
Crutu A.,
Florea V.,
SoummerFeulliet S.,
Baldeyrou P.
Publication year - 2016
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12263
Subject(s) - medicine , radiology , mesothelioma , thoracoscopy , endobronchial ultrasound , biopsy , pleural disease , pleural cavity , fine needle aspiration , pathological , bronchoscopy , pathology , lung , respiratory disease , surgery
Objective The aims of the present study were to investigate the role of endobronchial ultrasound‐guided transbronchial needle aspiration ( EBUS ‐ TBNA ) in the diagnosis of malignant pleural mesothelioma ( MPM ), and to identify specific clinical settings in which this procedure can be recommended. Methods We retrospectively reviewed the clinical and pathological files of patients having undergone EBUS ‐ TBNA from February 2011 to October 2014 to investigate thoracic lesions. Among 736 patients, we identified four of them with a diagnosis of MPM achieved primarily through EBUS ‐ TBNA . The diagnosis was made on formalin‐fixed paraffin‐embedded cell blocks, by checking the expression of mesothelial and carcinomatous‐specific markers. Results In all patients, the collected tissue was adequate, and the histological analysis in association with immunohistochemistry led us to the diagnosis of malignant pleural mesothelioma. In three patients, the diagnosis of mesothelioma was clinically suspected, as patients presented with diffuse pleural thickening. In two patients, videothoracoscopy was not possible owing to the ‘dry’ presentation of the pleural disease and the site of thickening. In this setting, EBUS ‐ TBNA was considered, at a multidisciplinary consensus meeting, as the most adequate available method to obtain a histological diagnosis. Conclusion EBUS ‐ TBNA may be a valuable diagnostic technique in the field of pleural pathology in selected clinical settings. More specifically ‘dry’ mesothelioma forming para‐tracheal nodules or masses not accessible by surgery or by computed tomography/ultrasonogaphy‐guided needle biopsy constitutes a good indication to perform EBUS ‐ TBNA .