Methods for Staging Non-small Cell Lung Cancer

Silvestri, Gerard A.; Gonzalez, Anne V.; Jantz, Michael A.; Margolis, Mitchell L.; Gould, Michael K.; Tanoue, L.T.; Harris, Loren J.; Detterbeck, Frank C.

doi:10.1378/chest.12-2355

Cited by 1,195 publications

(543 citation statements)

References 336 publications

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“…The quality of CB samples are highly promising especially for ALK, ROS1 and PD-L1 typing, when bigger samples are needed. A complication rate observed in our study was comparable with the standard EBUS-TBNA [1,2,[6][7][8].…”

Section: Discussionsupporting

confidence: 73%

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Initial Polish Experience of Flexible 19 Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Gnass

Sola²,

Filarecka³

et al. 2017

Advances in Respiratory Medicine

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Introduction: EBUS is a well established minimally invasive diagnostic tool for mediastinal and hilar lymphadenopathy. The novel ViziShot Flex 19G needle (Olympus Respiratory America, Redmond, WA, USA) was introduced in 2015 in order to improve loaded scope flexion and to obtain larger tissue samples for analysis. The aims of this study were to assess diagnostic yield of Flex 19G needles and to present endoscopist's feedback about the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Material and methods:The Flex 19G needles were used in patients with hilar and/or mediastinal adenopathy in two Polish pulmonology centers. Cytology smears and cell blocks (CB) were prepared. The prospective analysis was performed due to collected data. Results: Twenty two selected patients with confirmed adenopathy on chest-CT (mean age 58 ± 12) underwent EBUS-TBNA with use of Flex 19G needles. All procedures occurred to be diagnostic for smears (yield 100%). The malignancy was found in 15 cases (68.2%), and benign adenopathy in 7 (31.8%). In 12 of 14 cases of lung cancer (yield 85.7%) CB were diagnostic for immunohistochemical and molecular staining. After puncturing nodes, especially in hilar position not extensive bleeding was observed. Comparing to standard 21/22G EBUS-TBNA endoscopists underlined better flexion of loaded scope and sample adequacy and found non-significant differences in another biopsy details. Conclusions:The first Polish experience with use of Flex 19G EBUS-TBNA needle occurs to be similar in performance with standard technique with use of 22/21G needles and presents high diagnostic yield for lung cancer diagnostics, especially when preparing CB. A safety profile of the biopsy is acceptable.

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Section: Discussionsupporting

confidence: 73%

“…But the small number of selected patients must be underlined regarding reported in the literature diagnostic yield of this procedure in lung cancer staging -89%, and in mediastinal lymphadenopathy -92% [6,7].…”

Section: Discussionmentioning

confidence: 99%

Initial Polish Experience of Flexible 19 Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Gnass

Sola²,

Filarecka³

et al. 2017

Advances in Respiratory Medicine

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“…Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is an established modality for mediastinal staging in lung cancer patients with radiologically suspected lymph node metastasis 4. Definitive diagnosis of LCNEC (according to the new criteria) using EBUS‐TBNA samples would enable the selection of an appropriate therapeutic strategy for patients with this unique subtype of lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Pathological diagnosis of pulmonary large cell neuroendocrine carcinoma by endobronchial ultrasound‐guided transbronchial needle aspiration

et al. 2017

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BackgroundPulmonary large cell neuroendocrine carcinoma (LCNEC) is a relatively rare subtype of lung malignancy. According to revised 2015 World Health Organization (WHO) criteria for the pathological diagnosis of LCNEC, neuroendocrine markers must be examined by immunohistochemistry. In this study, we reevaluated endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) samples of patients previously diagnosed with LCNEC using the revised WHO criteria.MethodsClinical tissue samples that had been obtained by EBUS‐TBNA between January 2004 and December 2011, and that had been pathologically diagnosed as LCNEC according to the previous criteria, were reevaluated according to the revised WHO criteria.ResultsThe records of 471 lung cancer patients with mediastinal or hilar lymph node metastasis diagnosed by EBUS‐TBNA were analyzed. Thirteen patients were diagnosed with LCNEC; one of which was diagnosed based on cytology alone because the histological material was insufficient for a histological examination. Among the 12 cases in which a histological examination was performed, nine were diagnosed with possible LCNEC based on neuroendocrine marker positivity, while three were diagnosed with suspected LCNEC because they did not meet the immunostaining criteria. The patient who was cytologically diagnosed was found to have non‐small cell carcinoma with neuroendocrine morphology.ConclusionLCNEC could be pathologically diagnosed based on 2015 WHO criteria using EBUS‐TBNA samples.

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“…Up to date, these ultrasound-guided needle techniques (EBUS-TBNA and/or EUS-FNA) are recommended as the best first test in lung cancer patients with suspicious lymph node enlargement [28]. This recommendation in the guidelines of the American College of Chest Physicians is based on different meta-analyses.…”

Section: Diagnosis Of Hilar-mediastinal Lymphadenopathy and Mediastinmentioning

confidence: 99%

Role of Endobronchial and Endoscopic Ultrasound in Pulmonary Medicine

Gompelmann

Herth²

2013

Respiration

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In the last decade, endobronchial ultrasound (EBUS) has evolved into an important tool for diagnostic bronchoscopy in daily practice. EBUS has established as a standard for the diagnosis of hilar or mediastinal lymphadenopathy, as a guidance technique for peripheral pulmonary lesions and for the evaluation of tumor involvement of the tracheobronchial wall or mediastinum. In the meantime, EBUS has also taken a significant role in mediastinal staging in lung cancer patients. However, EBUS plays not only a role in the diagnosis of malignancies, it is also important for the diagnosis of benign disorders.

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Methods for Staging Non-small Cell Lung Cancer

Cited by 1,195 publications

References 336 publications

Initial Polish Experience of Flexible 19 Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Initial Polish Experience of Flexible 19 Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Pathological diagnosis of pulmonary large cell neuroendocrine carcinoma by endobronchial ultrasound‐guided transbronchial needle aspiration

Role of Endobronchial and Endoscopic Ultrasound in Pulmonary Medicine

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