[Role of ultrasound-guided endoscopy in the evaluation of mediastinal lesions].
The evaluation of the mediastinum is still a challenge. In most cases, a pathologic study is mandatory for therapeutic decision-making. In this setting, endoscopic ultrasonography (EUS) without and with fine needle aspiration (FNA) is currently considered as a very useful and safe non-invasive technique since it overcomes most problems raising from standard radiologic techniques at the time of obtaining histologic confirmation. Moreover, it avoids the surgical approach for diagnosis in a significant number of patients. Thus, performance characteristics (sensitivity, specificity and accuracy) of EUS FNA in the diagnosis of mediastinal lymph nodes of unknown origin are higher than 90%. The place of EUS FNA in the staging of lung cancer is not well established yet, but available data suggest that it can play a major role in patients with negative transbronchial biopsy or even in the initial evaluation regardless of CT results. Finally, recent studies also suggest that EUS FNA is the most cost-effective non-surgical technique for the study of the mediastinum.
Vázquez-Sequeiros
Enrique
E
Sección de Endoscopia Digestiva (ecoendoscopia). Servicio de Gastroenterología. Hospital Ramón y Cajal. Madrid. España.
Ginès
Angels
A
Wiersema
Maurits J
MJ
D001707:Biopsy, Needle / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D019160:Endosonography / Q000191:economics / Q000379:methods*; D006801:Humans; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008481:Mediastinoscopy / Q000191:economics / Q000379:methods*