title: The role of endobronchial ultrasound-guided fine needle aspiration in the diagnosis of pleural mesothelioma.
abstract: OBJECTIVE
  The aims of the present study were to investigate the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of malignant pleural mesothelioma (MPM), and to identify specific clinical settings in which this procedure can be recommended.
  
  
  METHODS
  We retrospectively reviewed the clinical and pathological files of patients having undergone EBUS-TBNA from February 2011 to October 2014 to investigate thoracic lesions. Among 736 patients, we identified four of them with a diagnosis of MPM achieved primarily through EBUS-TBNA. The diagnosis was made on formalin-fixed paraffin-embedded cell blocks, by checking the expression of mesothelial and carcinomatous-specific markers.
  
  
  RESULTS
  In all patients, the collected tissue was adequate, and the histological analysis in association with immunohistochemistry led us to the diagnosis of malignant pleural mesothelioma. In three patients, the diagnosis of mesothelioma was clinically suspected, as patients presented with diffuse pleural thickening. In two patients, videothoracoscopy was not possible owing to the 'dry' presentation of the pleural disease and the site of thickening. In this setting, EBUS-TBNA was considered, at a multidisciplinary consensus meeting, as the most adequate available method to obtain a histological diagnosis.
  
  
  CONCLUSIONS
  EBUS-TBNA may be a valuable diagnostic technique in the field of pleural pathology in selected clinical settings. More specifically 'dry' mesothelioma forming para-tracheal nodules or masses not accessible by surgery or by computed tomography/ultrasonogaphy-guided needle biopsy constitutes a good indication to perform EBUS-TBNA.
authors: Department of Pathology, Marie Lannelongue Surgical Centre, Le Plessis-Robinson, France.
authors: M R
authors: MR
authors: Ghigna
authors: Department of Thoracic and Vascular Surgery, Marie Lannelongue Surgical Centre, Le Plessis-Robinson, France.
authors: A
authors: A
authors: Crutu
authors: Department of Thoracic and Vascular Surgery, Marie Lannelongue Surgical Centre, Le Plessis-Robinson, France.
authors: V
authors: V
authors: Florea
authors: Department of Thoracic and Vascular Surgery, Marie Lannelongue Surgical Centre, Le Plessis-Robinson, France.
authors: S
authors: S
authors: Soummer-Feulliet
authors: Department of Thoracic and Vascular Surgery, Marie Lannelongue Surgical Centre, Le Plessis-Robinson, France.
authors: P
authors: P
authors: Baldeyrou
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000302:isolation & purification; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor
keywords: cytology; mesothelioma