Accuracy and safety of EUS-B-FNA in the diagnosis of lung parenchymal lesions

Endoscopic ultrasound (with bronchoscope) fine needle aspiration (EUS-B-FNA) has been recognized as a useful and safe technique in sampling mediastinal lymph nodes. Few data are available on its accuracy in diagnosing pulmonary parenchymal lesions adjacent to the esophagus.We performed an observational, retrospective study aimed to evaluate accuracy and safety of EUS-B-FNA for lung parenchymal abnormalities, in two Italian reference centers. Furthermore, impact of rapid on-site evaluation (ROSE) and lesion anatomical site (i.e. lobe) on diagnostic yield were assessed.From November 2016 to January 2018, 21 patients (52.4% males; mean (SD) age: 67.7 (10.9) years) with parenchymal lesions (mean (SD) long axis 49.9 (13.6) mm) underwent EUS-B-FNA. 10/21 (47.6%) patients underwent endosonography with ROSE.EUS-B-FNA showed a diagnostic yield of 85.7% (18/21), not influenced by ROSE (9/11 (81.8%) VS. 9/10 (90.0%); p-value: 1.0) and by lesion location (left lower lobe 2 (100%), left upper 4 (100%), right lower 7 (77.8%), right upper 5 (83.3%); p-value: 1.0).Non-small cell lung cancer was diagnosed in 15/21 (71.4%) patients (11 adenocarcinomas and 4 squamocellular carcinomas), whereas small cell lung cancer in 2/21 (9.5%). 1/21 (4.7%) and 3/21 (14.3%) patients showed benign lesions and not diagnostic findings, respectively. Only one small pneumothorax was recorded.EUS-B-FNA is an accurate and safe technique to diagnose lung parenchymal lesions close to the esophagus. ROSE presence and ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research