Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer

Fernández-Bussy, Sebastián; Labarca, Gonzalo; Canals, Sofia; Caviedes, Iván; Folch, Erik; Majid, Adnan

doi:10.1590/s1806-37132015000004466

Cited by 22 publications

(16 citation statements)

References 11 publications

(32 reference statements)

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“…The diagnostic bronchoscopic yield of 49.2% for suspected thoracic malignancy at our institution was similar to other studies. [ 6 , 7 , 10 , 11 ] Consistent with other reports, the diagnostic yield was higher in the presence of endobronchial lesions or performance of EBUS-TBNA [ 8 , 12 , 13 , 14 , 15 ] Our study did not identify any demographic, clinical factors or radiographic findings predictive of a diagnostic or non-diagnostic bronchoscopy. The time frame to establish the diagnosis was variable; the main contributing factors included difficulty in contacting and tracing patients, patients missing follow up appointments, time waiting for additional imaging required prior to scheduling further interventions, waiting time to be seen by other specialist and booking of additional procedures.…”

Section: Discussionsupporting

confidence: 90%

Outcomes of patients with a non-diagnostic initial bronchoscopy for suspected thoracic malignancy

et al. 2020

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Lung cancer is 1 of the leading causes of cancer-related deaths and bronchoscopy is an essential tool for the diagnosis. The diagnostic yield varies based on the characteristics of the lesion and bronchoscopic techniques employed. There is limited data regarding outcomes of patients suspected of thoracic malignancies with a non-diagnostic initial bronchoscopy. The goal of the study was to evaluate the outcomes of patients with a non-diagnostic bronchoscopy for suspected thoracic malignancies and to evaluate variables predictive of a diagnostic bronchoscopy. Retrospective analysis of adult patients at BronxCare Hospital Center who underwent bronchoscopy for suspected thoracic malignancy. The study period was January 2012 to February 2019. Exclusion criteria included patients who underwent only inspection bronchoscopy or bronchoalveolar lavage as the diagnostic yield for malignancy with these techniques is low. All other bronchoscopic procedures were included that is, endobronchial biopsies, transbronchial biopsies, and endobronchial ultrasound guided-transbronchial needle aspiration. Bronchoscopy was considered diagnostic when a specific histopathological diagnosis was established. 311 patients underwent bronchoscopy to rule out malignancy. A diagnosis was obtained in 153 (49.2%) patients, 81 (52.9%) had primary lung cancer and 14 (9.15%) other malignancies. 158 (50.8%) patients had initial non-diagnostic bronchoscopy; 86 (54.43%) were lost to follow up. Of the remaining 72 (45.57%) patients, radiological resolution or stability was observed in 51 (70.8%) patients. Primary lung cancer was found in 13 (18.05%) patients and other malignancies in 5 (6.94%). Predictive of a diagnostic bronchoscopy was the performance of endobronchial biopsies and endobronchial ultrasound guided-transbronchial needle aspiration. This study highlights some of the barriers to the timely diagnosis of thoracic malignancies. Following patients with a non-diagnostic procedure as well as all those patients with diagnosed malignancies it of the utmost importance. In patients available for follow up, close to 25% of additional cases with treatable malignancy could be identified and patients diagnosed with cancer could receive timely treatment.

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Section: Discussionsupporting

confidence: 90%

Outcomes of patients with a non-diagnostic initial bronchoscopy for suspected thoracic malignancy

et al. 2020

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“…The remaining 42 records were assessed in the full text. Of those, 14 were included as they corresponded to the search criteria ( Table 1) (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). The size of the cohorts varied from 30 to 802 patients, with a total number of 3,550 patients.…”

Section: Methodsmentioning

confidence: 99%

Endobronchial ultrasound-transbronchial needle aspiration (EBUS/TBNA): a diagnostic challenge for mediastinal lesions

et al. 2018

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Lung cancer is one of the most frequent neoplastic diseases. To date, most lung cancer is diagnosed at an advanced stage, making it difficult to choose the diagnostic and therapeutic strategy. Surgical resection represents the best therapeutic solution. However, the best results are obtained only in the early stages of the disease. Lymph node involvement conditions the treatment (surgical or non-surgical approach). Mediastinoscopy is an effective and widely used method for mediastinal staging but does not allow us to reach many mediastinal lymph nodes. Endobronchial ultrasound/transbronchial needle aspiration (EBUS-TBNA) allows us to reach more lymph nodes and is referred to as a first-choice exam for mediastinal staging.

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“…Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is an invaluable tool for mediastinal lymph node staging in patients suspected to have lung cancer with a sensitivity and a specificity of 91.17% and 100.0% respectively with an excellent safety profile The use of EBUS in the diagnosis of PE has been reported with success in multiple studies [6][7][8]. This is especially important when CT pulmonary angiography is contraindicated.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Artery Sarcoma Diagnosed by Transbronchial Endosonographic (EBUS-TBNA) Approach

Frangia-Tsivou¹,

Alsaid²,

Karetsi³

et al. 2020

SCR

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Background: Pulmonary Artery Sarcomas are the rarest and the most aggressive vascular tumors. Their accurate diagnosis is challenging due to the lack of specific symptoms and clinical manifestations and they are often initially misdiagnosed and managed as chronic pulmonary thromboembolic disease until an alternate diagnosis is suspected based on the lack of response to anticoagulants. Proper management is thus often delayed until histological confirmation. Moreover, the lack of consensus regarding their diagnosis and treatment further contributes to their reported high mortality [1]. Case Presentation: We present the case of a 34-year-old male, nonsmoker, who presented with hemoptysis, fatigue and dyspnea on exertion 3 months prior to admission. His chest x-ray showed enlargement of the left hilum and chest CT revealed a large intraluminal low attenuation filling defect at the level of the left PA. Chest MRI confirmed the presence of a large endovascular tumor of the left PA. Before referring the patient for surgical biopsy, he underwent bronchoscopy during which the vascular tumor was successfully located, observed and sampled by endobronchial ultrasound (EBUS) transbronchial needle aspiration (TBNA). Tissue biopsy through EBUS-TBNA revealed an intimal sarcoma of the PA. The patient was subsequently referred for surgical excision with curative intent. Conclusion: Bronchoscopy and EBUS-TBNA may safely and accurately diagnose even rare pathologies of the mediastinal vasculature adjacent to the airways through transbronchial approach.

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Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer

Cited by 22 publications

References 11 publications

Outcomes of patients with a non-diagnostic initial bronchoscopy for suspected thoracic malignancy

Outcomes of patients with a non-diagnostic initial bronchoscopy for suspected thoracic malignancy

Endobronchial ultrasound-transbronchial needle aspiration (EBUS/TBNA): a diagnostic challenge for mediastinal lesions

Pulmonary Artery Sarcoma Diagnosed by Transbronchial Endosonographic (EBUS-TBNA) Approach

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