Endoscopic ultrasound with fine needle aspiration and biopsy in lung cancer and isolated mediastinal lymphadenopathy.
Endoscopic ultrasound with fine-needle aspiration and biopsy (EUS-FNAB) is well established in diagnosing and staging lung cancer in patients with mediastinal adenopathy. EUS-FNAB is highly sensitive, less invasive and has lower complication rates when compared to surgical staging of mediastinal nodes. In this study we describe our experience of EUS-FNAB in lung cancer and other causes of mediastinal lymphadenopathy. EUS-FNAB was performed for assessment of PET positive mediastinal lymph nodes between January 2007 and March 2009 in AMNCH. The endpoints of our study were sensitivity and specificity of EUS-FNAB, morbidity and length of hospital stay. Thirty four patients underwent EUS-FNAB during the study period for both diagnosis and staging. Thirty patients had positive lymph node invasion and 4 had no evidence of malignant invasion. In these 4 patients negative cytology was confirmed on mediastinoscopy giving EUS-FNAB a sensitivity and specificity of 100%. EUS-FNAB upstaged the disease in 12 patients. EUS-FNAB is a reliable tool for mediastinal staging in lung cancer, significantly reducing the need for surgical staging procedures in patients with suspected mediastinal involvement.
Nadarajan
P
P
AMNCH, Tallaght, Dublin 24. sonadarp2@yahoo.ie
Sulaiman
I
I
Kent
B
B
Breslin
N
N
Moloney
E D
ED
Lane
S J
SJ
D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001999:Bronchoscopy; D019160:Endosonography; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed