Clinical utility of EUS-guided fine-needle aspiration of mediastinal masses in the absence of known pulmonary malignancy.
BACKGROUND
Mediastinal masses represent a diagnostic challenge because of their proximity to numerous critical structures, difficulty of access for tissue sampling, and myriad potential pathologic etiologies. A large, single-center experience with EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis of non-lung cancer-related mediastinal masses is presented.


METHODS
An EUS database was reviewed and all cases of mediastinal mass or lymphadenopathy encountered between 1994 and 1999 were included. Final diagnoses were determined by EUS-FNA cytology and clinical follow-up.


RESULTS
Forty-nine patients were identified (27 women, 22 men; mean age 58.1 years, range 30-89 years). A malignant process was diagnosed in 22 cases (45%) and a benign process in 24 (49%). The EUS-FNA specimen was nondiagnostic in 3 cases (6%). An accurate diagnosis was made in 46 of the 49 patients (94%). No complication was noted.


CONCLUSIONS
EUS-FNA is a minimally invasive technique that facilitates detection and tissue sampling of mediastinal masses. It is a safe procedure that can be performed with the patient under conscious sedation in an outpatient setting.
Indiana University Medical Center, Indianapolis, Indiana 46202, USA.
Benedict M
BM
Devereaux
Julia Kim
JK
Leblanc
Edward
E
Yousif
Kenneth
K
Kesler
JoAnn
J
Brooks
Praveen
P
Mathur
Alan
A
Sandler
John
J
Chappo
Glen A
GA
Lehman
Stuart
S
Sherman
Frank
F
Gress
Donato
D
Ciaccia
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies