title: Use of endobronchial ultrasound to evaluate nonthrombotic endovascular lesions in pulmonary arteries: a systematic review.
abstract: BACKGROUND
  The finding of a filling defect in a pulmonary artery (PA) sometimes raises the possibility of cancer. Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) may confirm the underlying nature of the endovascular lesion. However, little is known about the use of this procedure for this purpose.
  
  
  METHODS
  We searched PubMed and abstracts of major international conferences.
  
  
  RESULTS
  There was a total of 12 cases: 8 female, 3 male, and 1 unknown. The median (range) age was 60 (51 to 79) years. EBUS was performed to evaluate mass-like lesion involving the PA (n=5), persistent or progressive filling defects in the PA despite anticoagulation (n=3), filling defect in the PA with multiple areas of consolidation, air-fluid levels in the lung (n=1), and hilar density (n=1). Moreover, an endovascular lesion was incidentally noted in the PA during EBUS for evaluating lymph nodes (n=2). EBUS-TBNA was diagnostic in 9 of the 10 cases in which it was performed. The final diagnoses were: sarcoma (n=6), lung cancer (n=2), thyroid cancer (n=1), renal cell cancer (n=1), melanoma (n=1), and pulmonary embolism (n=1). The cancer was a recurrence in 6 of the 7 cases with a known history of cancer.
  
  
  CONCLUSIONS
  EBUS should be considered as a possible method for evaluating endovascular lesions when PA sarcoma or tumor macroembolism is suspected.
authors.affiliation: *Department of Medicine †Division of Pulmonary and Critical Care Medicine, University of Florida, Jacksonville, FL.
authors.forename: Farah
authors.initials: F
authors.lastname: Al-Saffar
authors.forename: Saif
authors.initials: S
authors.lastname: Ibrahim
authors.forename: Vandana
authors.initials: V
authors.lastname: Seeram
authors.forename: Abubakr A
authors.initials: AA
authors.lastname: Bajwa
authors.forename: Adil
authors.initials: A
authors.lastname: Shujaat
mesh_terms: D000368:Aged; D001999:Bronchoscopy / Q000295:instrumentation*; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000473:pathology*; D012509:Sarcoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D019043:Vascular Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology