EUS-FNA as the initial diagnostic modality in centrally located primary lung cancers.
OBJECTIVE
The need to safely and accurately diagnose lung neoplasms is crucial as the only prospect for a cure is surgical resection. A small amount of data exists on the use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) as the initial diagnostic modality of primary lung cancer.


METHODS
We performed a retrospective review of an established prospective database of all patients undergoing EUS-FNA of a primary lung neoplasm adjacent to the esophagus during January 2001 to August 2005 in one tertiary care center. The indications for the procedure, diagnostic accuracy, and complications were reviewed.


RESULTS
A total of 17 cases (9 females, 8 males) were identified. The mean age was 66 (SD 10.6). There were 9 lesions within the hilum and 8 lesions within the upper lobes. The median size of the lung lesions was 5 (range 2 to 12)x4 (range 2 to 9) cm. The median and mean number of FNA passes was 3. All the procedures provided an accurate diagnosis of the primary lung lesion without need for further intervention. One patient with active hemoptysis was transiently hospitalized for aspiration pneumonia postprocedure.


CONCLUSIONS
EUS-FNA is a safe, relatively cost-effective, and accurate initial diagnostic modality for the diagnosis of lung lesions adjacent to the esophagus or invading the mediastinum. Although further randomized prospective trials are warranted, this modality should be considered as a first step in the diagnostic armamentarium in centrally located lung lesions.
Digestive Health Center of Excellence, Department of Radiology, University of Virginia, Charlottesville, VA 22908, USA.
Alfredo
A
Hernandez
Michel
M
Kahaleh
Juan
J
Olazagasti
David R
DR
Jones
Thomas
T
Daniel
Edward
E
Stelow
Grace E
GE
White
Vanessa M
VM
Shami
D008175:Lung Neoplasms / Q000175:diagnosis*