Endoscopic ultrasound-guided fine needle aspiration in the evaluation of suspected lung cancer.
OBJECTIVE
The role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis and staging of lung cancer is still not fully explored. This prospective study aimed to define the effectiveness of EUS-FNA as an adjunct to computer tomography (CT) and bronchoscopy in the evaluation of suspected lung cancer in routine clinical practice.


METHODS
Over a period of 20 weeks, the data of 16 consecutive patients suspected of lung cancer on account of respiratory symptoms, and/or the findings of either a mass or mediastinal lymph nodes on helical CT, who were referred for evaluation by EUS, were prospectively collected. Fourteen of these patients underwent sequential bronchoscopy followed by EUS-FNA in the same setting.


RESULTS
Bronchoscopy was performed in 15 patients, while EUS was performed in all 16 patients. Bronchoscopy diagnosed 9 cases of non-small-cell lung cancer (NSCLC) but was falsely negative in 3 cases of malignancies, which were all established by EUS-FNA of mediastinal lymph nodes (2 cases of NSCLC and 1 case of esophageal squamous cell cancer). EUS-FNA also diagnosed advanced NSCLC in another patient who did not undergo bronchoscopy, such that eventually 13 patients were diagnosed to have malignancies. Distant metastases were diagnosed by EUS-FNA in 4 cases of NSCLC (2 cases of left adrenal gland and 2 cases of pancreatic metastases). Two patients were diagnosed to have sarcoidosis and 1 patient was diagnosed to have pneumoconiosis eventually.


CONCLUSIONS
EUS-FNA is useful as an adjunct to CT and bronchoscopy in the evaluation of suspected lung cancer.
Ang
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TL
Division of Gastroenterology, Changi General Hospital, 2 Simei St. 3, Singapore 529889, Singapore. tiing_leong_ang@cgh.com.sg
Tee
A K H
AK
Fock
K M
KM
Teo
E K
EK
Chua
T S
TS
D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D001999:Bronchoscopy / Q000379:methods; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000556:secondary; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional / Q000379:methods*