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Transoesophageal needle aspiration using a convex probe ultrasonic bronchoscope
Author(s) -
HWANGBO Bin,
LEE Hee Seok,
LEE GeonKook,
LIM KunYoung,
LEE SooHyun,
KIM HyaeYoung,
LEE JongYeul,
ZO Jae Ill
Publication year - 2009
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2009.01590.x
Subject(s) - medicine , radiology , fine needle aspiration , bronchoscopy , endoscopic ultrasound , malignancy , endobronchial ultrasound , ultrasound , lung cancer , metastasis , biopsy , cancer , pathology
Background and objective: Although endoscopic ultrasound‐guided fine needle aspiration can be helpful when combined with bronchoscopic procedures, endoscopic ultrasound‐guided fine needle aspiration is not available as a conjunctive procedure with bronchoscopy at many institutions. This study evaluated the feasibility and the additional role of transoesophageal fine needle aspiration using a convex probe ultrasonic bronchoscope (EUS‐B‐FNA). Methods: We analysed 84 patients who underwent EUS‐B‐FNA between Oct 2007 and May 2008. Bronchoscopy and/or endobronchial ultrasound‐guided transbronchial needle aspiration was performed on 83 patients prior to EUS‐B‐FNA. Results: EUS‐B‐FNA was performed on 89 lesions (1.7 aspirations/lesion) including three lung masses and 86 lymph nodes (nodal stations 1, 3P, 4L, 5, 7, 8, 9 and 10L) without complication. Sample adequacy was 95.4% for each aspiration and 100% for each lesion. Of the 89 lesions, 39 malignant lesions were confirmed by EUS‐B‐FNA. EUS‐B‐FNA provided additional diagnostic gain to bronchoscopic procedures in 16 patients (19.0%): 3 lung cancers were upstaged, 11 lung cancers were pathologically confirmed, and 2 patients were diagnosed with mediastinal metastasis from an extrathoracic malignancy. This gain was obtained by the sampling of inaccessible ( n = 4) or difficult lesions by endobronchial ultrasound‐guided transbronchial needle aspiration ( n = 2) or when bronchoscopy was difficult due to dyspnoea, cough, brain metastasis or other conditions ( n = 10). Conclusions: EUS‐B‐FNA is a technically feasible and safe procedure, which may be an alternative to endoscopic ultrasound‐guided fine needle aspiration as a procedure that complements bronchoscopy. Additional diagnostic yield can be obtained by combining EUS‐B‐FNA with bronchoscopic procedures.