[Transesophageal endosonographically-guided fine needle aspiration biopsy of mediastinal space-occupying lesions of uncertain importance].
OBJECTIVE
Endoscope-guided fine-needle biopsy of mediastinal space-occupying lesions is a recently introduced method of low invasiveness. This is a report of the authors' experience.


METHODS
Between Nov. 1996 and April 1999 endoscope-guided mediastinal biopsies (Pentax FG 32 UA) were performed in 31 patients (eight women, 23 men; aged 27-80 years). The space-occupying lesion had to be less than 1 cm from the oesophagus and not more easily approachable in other ways.


RESULTS
The method was successful in 23 of the 31 patients (74%). In ten of the 31 patients (32%) a malignant lesion was histologically proven. In six patients (19%) sarcoidosis was revealed. Of the eight patients with inadequate biopsy material a malignancy was ultimately diagnosed in three, sarcoidosis in one (in three by mediastinoscopy, in one by laparoscopy). Thus the sensitivity of diagnosing a malignancy was 77%, with a specificity of 100%. Follow-up examinations in the remaining four patients excluded a malignancy.


CONCLUSIONS
Endoscope-guided fine-needle biopsy of mediastinal space-occupying lesions is a technically simple method causing little stress to the patient that can frequently elucidate the lesion's benignity or malignancy. Invasive procedures, such as mediastinoscopy, may thus be avoided in some patients.
Pauw
M
M
Medizinische Klinik, Kliniken Maria Hilf GmbH, Krankenhaus St. Franziskus, Mönchengladbach. Kohnen-Pauw@t-online.de
Trenn
G
G
Heuer
T
T
Reis
H E
HE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D012507:Sarcoidosis / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity