title: Transoesophageal endoscopic ultrasound-guided fine-needle aspiration of pleural effusion for the staging of non-small cell lung cancer.
abstract: OBJECTIVE
  The efficacy of endoscopic ultrasound (EUS) for evaluating mediastinal adenopathy in lung cancer is nowadays proven. However, its accuracy for detection of malignant pleural effusion per se has not been yet investigated. Herein we report our experience with EUS for detecting pleural effusion during the staging procedure of non-small cell lung cancer (NSCLC) patients.
  
  
  METHODS
  Between January 2009 and December 2011, we performed endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) on 92 selected NSCLC patients to evaluate the T and N factors and to acquire bioptic material and when this was detected, to sample the pleural effusion.
  
  
  RESULTS
  In 10 patients (8 males and 2 females, mean age 66.9±9.2 years) a pleural effusion was detected and sampled. In 7 out of the 10 cases, the cytological examination of the fluid obtained by EUS-FNA tested positive for malignant cells, thereby upgrading the case to Stage IV, irrespective of T and N statuses. In 3 cases the cytology on the EUS-FNA material was proven to be negative for malignancy thereby allowing patients to be treated with curative intent without further delay.
  
  
  CONCLUSIONS
  EUS-FNA of the pleural fluid is a safe and simple procedure. Our data, albeit stemming from a limited study population, show that it can be efficient in selected NSCLC cases for obtaining useful material and information with significant impact on the staging and, therefore, on the planning of the optimum therapeutic strategy.
authors.affiliation: Department of Thoracic Surgery, Catholic University, Rome, Italy. filippo_lococo@yahoo.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Lococo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Cesario
authors.forename: Fabia
authors.initials: F
authors.lastname: Attili
authors.forename: Marco
authors.initials: M
authors.lastname: Chiappetta
authors.forename: Giovanni
authors.initials: G
authors.lastname: Leuzzi
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Granone
authors.forename: Alberto
authors.initials: A
authors.lastname: Larghi
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000473:pathology* / Q000628:therapy; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016066:Pleural Effusion, Malignant / Q000209:etiology / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: EUS-FNA; NSCLC; Pleural effusion