Open AccessEndobronchial ultrasound‐guided transbronchial needle aspiration and its role in non‐small cell lung cancer: Diagnostic impact and limitations
Author(s) -
Dango Sebastian,
Guenter Jutta,
Passlick Bernward
Publication year - 2010
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/j.1759-7714.2010.00014.x
Subject(s) - mediastinoscopy , medicine , radiology , lung cancer , endobronchial ultrasound , mediastinal lymph node , lymph node , fine needle aspiration , biopsy , endoscopic ultrasound , bronchoscopy , cancer , pathology , metastasis
A diagnostic work‐up to evaluate possible mediastinal lymph node involvement in patients with non‐small cell lung cancer (NSCLC) should be performed once suspected as a result of computed tomography. Cytological/histological verification is always compulsory. In recent years, diagnostic tools for mediastinal evaluation have made great technical progress with the introduction of endosonographic real‐time ultrasound techniques such as endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA). Mediastinal masses as well as lymph node enlargement can be clarified by endosonographic guided biopsies and play a key role in cytological examination of mediastinal lymph nodes. The proven high sensitivity of endosonographic guided biopsies and the high negative predictive value of 20% may challenge mediastinoscopy, which has a sensitivity of 80–95%. However, with a higher positive predictive value and being the best explored method in the literature, mediastinoscopy still has a better diagnostic yield for mediastinal staging. However, according to us EBUS‐TBNA should be considered for staging in patients with NSCLC primarily, but negative results must be followed by mediastinoscopic evaluation.