Transoesophageal needle aspiration using a convex probe ultrasonic bronchoscope.
OBJECTIVE
Although endoscopic ultrasound-guided fine needle aspiration can be helpful when combined with bronchoscopic procedures, endoscopic ultrasound-guided fine needle aspiration is not available as a conjunctive procedure with bronchoscopy at many institutions. This study evaluated the feasibility and the additional role of transoesophageal fine needle aspiration using a convex probe ultrasonic bronchoscope (EUS-B-FNA).


METHODS
We analysed 84 patients who underwent EUS-B-FNA between Oct 2007 and May 2008. Bronchoscopy and/or endobronchial ultrasound-guided transbronchial needle aspiration was performed on 83 patients prior to EUS-B-FNA.


RESULTS
EUS-B-FNA was performed on 89 lesions (1.7 aspirations/lesion) including three lung masses and 86 lymph nodes (nodal stations 1, 3P, 4L, 5, 7, 8, 9 and 10L) without complication. Sample adequacy was 95.4% for each aspiration and 100% for each lesion. Of the 89 lesions, 39 malignant lesions were confirmed by EUS-B-FNA. EUS-B-FNA provided additional diagnostic gain to bronchoscopic procedures in 16 patients (19.0%): 3 lung cancers were upstaged, 11 lung cancers were pathologically confirmed, and 2 patients were diagnosed with mediastinal metastasis from an extrathoracic malignancy. This gain was obtained by the sampling of inaccessible (n = 4) or difficult lesions by endobronchial ultrasound-guided transbronchial needle aspiration (n = 2) or when bronchoscopy was difficult due to dyspnoea, cough, brain metastasis or other conditions (n = 10).


CONCLUSIONS
EUS-B-FNA is a technically feasible and safe procedure, which may be an alternative to endoscopic ultrasound-guided fine needle aspiration as a procedure that complements bronchoscopy. Additional diagnostic yield can be obtained by combining EUS-B-FNA with bronchoscopic procedures.
Hwangbo
Bin
B
Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Ilsan-Gu, Goyang, Gyeonggi, Korea. hbb@ncc.re.kr
Lee
Hee Seok
HS
Lee
Geon-Kook
GK
Lim
Kun-Young
KY
Lee
Soo-Hyun
SH
Kim
Hyae-Young
HY
Lee
Jong-Yeul
JY
Zo
Jae Ill
JI
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D019160:Endosonography / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004947:Esophagus; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care