0
Clinical Investigations: TECHNIQUES |

Analysis of the Internal Structure of Peripheral Pulmonary Lesions Using Endobronchial Ultrasonography*

Noriaki Kurimoto, MD; Masaki Murayama, MD; Shinkichiro Yoshioka, MD; Takashi Nishisaka, MD
Author and Funding Information

*From the Department of Surgery (Dr. Kurimoto), National Hiroshima Hospital, Higashi-Hiroshima, Japan; the Department of Surgery (Dr. Murayama), Iwakuni Minami Hospital, Iwakuni, Japan; the Second Department of Surgery (Dr. Yoshioka), Hiroshima University School of Medicine, Hiroshima, Japan; and the Department of Pathology (Dr. Nishisaka), Hiroshima PrefecturalHospital, Hiroshima, Japan.

Correspondence to: Noriaki Kurimoto, MD, 513 Jike, Saijyoucyou, Higashi-Hiroshima City, Hiroshima Prefecture, 739-0041 Japan



Chest. 2002;122(6):1887-1894. doi:10.1378/chest.122.6.1887
Text Size: A A A
Published online

Study objective: To correlate the internal structure of peripheral pulmonary lesions, as visualized by endobronchial ultrasonography (EBUS), and the histology of the surgical specimen to develop a classification system for distinguishing benign from malignant lesions by EBUS.

Design: Retrospective review.

Setting: A national hospital.

Patients: One hundred twenty-four patients with peripheral pulmonary lesions who had undergone EBUS in whom a definitive histologic diagnosis was made. In 69 patients, EBUS findings were correlated with the histology of a surgical specimen.

Intervention: EBUS was performed by a miniature probe (20-MHz) introduced up to the lesion through a channel in a bronchoscope.

Results: Three classes and six subclasses of lesions were identified by EBUS based on the internal structure of the lesion, focusing on internal echoes, vascular and bronchial patency, and the morphology of the hyperechoic areas, reflecting air in the alveoli and bronchioles. The classes of lesions are as follows: type I, homogeneous pattern (type Ia, with patent vessels and patent bronchioles; type Ib, without vessels and bronchioles); type II, hyperechoic dots and linear arcs pattern (type IIa, without vessels; type IIb, with patent vessels); and type III, heterogeneous pattern (type IIIa, with hyperechoic dots and short lines; type IIIb, without hyperechoic dots and short lines). Twenty-three of 25 type I lesions (92.0%) were benign, while 98 of 99 type II and III lesions (99.0%) were malignant. Twenty-one of 24 type II lesions (87.5%) were well-differentiated adenocarcinomas, and all type IIIb lesions were malignant, including 18 poorly differentiated adenocarcinomas (81.8%).

Conclusions: EBUS permits the visualization of the internal structure of peripheral pulmonary lesions, and this information suggests the histology of the lesion.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543