Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of paraesophageal lung tumors – diagnostic yield and added value

Abstract

Aims: There are few data on the use of endoscopic ultrasound (EUS) for the biopsy of suspected malignant lesions of the lung. The main objective of this study was to evaluate the performance of transesophageal EUS fine needle aspiration (EUSFNA) for the diagnosis of paraesophageal lung tumors and also for the confirmation of metastatic sites of lung cancer during the same procedure.Material and methods: We performed a retrospective study in a tertiary care unit including 19 patientswith paraesophageal lung tumors referred to our department for a lung biopsy. Transesophageal EUS-FNA was performed using a linear echoendoscope and 22G needles.Results: In all 19 patients with suspected lung tumors the confirmation of the malignant disease was achieved. Pathological examination revealed 16 cases of non-small cell lung cancers, 2 small cell lung cancers and one case of lung metastases. Diagnostic yield of lung EUS-FNA was 1, with no post-procedural complications. In 7 cases, we performed also biopsies of suspected metastasis and all biopsies revealed the same histopathological type as the primary tumor.Conclusions: Our study supports the use of this minimally invasive technique for paraesophageally locatedlung tumors and demonstrates that EUS-FNA is safe and has an excellent diagnostic yield.

Accuracy of endoscopic ultrasound-guided biopsy of focal liver lesions

“…Concurrent biopsies of metastatic sites, other than the liver, during a single endoscopic procedure are another example of this versatility [28][29][30]. We were able to take a biopsy from the retroperitoneal lymph nodes, adrenal glands, lungs, vertebra and prostate.…”

Transesophageal endoscopic ultrasound-guided tissue acquisition of lung masses: a case series with systematic review and meta-analysis

“…Among the included studies, 17 were full-text articles [ 10 - 17 , 20 - 28 ], while 2 were conference abstracts [ 18 , 19 ]. Based on the study design, 6 studies were prospective [ 11 , 13 , 18 , 24 , 26 , 27 ], and the remaining 13 were retrospective [ 10 , 12 , 14 - 17 , 19 - 23 , 25 , 28 ]. The diagnostic test was EUS-FNA/FNB in 15 studies [ 10 - 21 , 24 , 25 , 28 ] and EUS-B-FNA [ 22 , 23 , 26 , 27 ] in 4 studies.…”

“…Based on the study design, 6 studies were prospective [ 11 , 13 , 18 , 24 , 26 , 27 ], and the remaining 13 were retrospective [ 10 , 12 , 14 - 17 , 19 - 23 , 25 , 28 ]. The diagnostic test was EUS-FNA/FNB in 15 studies [ 10 - 21 , 24 , 25 , 28 ] and EUS-B-FNA [ 22 , 23 , 26 , 27 ] in 4 studies. Ten studies used only a 22-G needle [ 10 - 12 , 14 , 16 , 21 , 22 , 24 - 26 ], 7 studies used a variety of needle sizes ranging from 19-25-G [ 15 , 17 , 18 , 20 , 23 , 27 , 28 ], and 2 studies did not report the type of needle used [ 13 , 19 ].…”

Transthoracic ultrasound: an essential diagnostic tool in a very rare case of thoracic lymphangiomatosis

“…Another important issue is represented by the potential severe complications of open biopsy in patients with TL as mentioned in the literature [8], which supports the need of a minimal invasive diagnostic approach, such as a US-guided biopsy. Concomitant with the advances of endoscopic ultrasound FNA, which is feasible even for paraesophageal lung tumors [9], it is obvious that the intrathoracic organs benefit from another technique that can procure minimally invasive biopsies.…”