PURPOSE: The diagnosis of small peripheral pulmonary lesions (PPLs) is technically challenging. Endobronchial ultrasound (EBUS) has been used to increase the likelihood of success. Nevertheless, the diagnostic yield of PPLs which diameter less than 2 cm is still low. EBUS guide sheath with transbronchial lung biopsy (EBUS-GS-guided TBLB) may resolve this problem. The purpose of this study was to assess the diagnostic yield of EBUS-GS-guided TBLB in PPLs of less than 2 cm.
METHODS: Patients with small PPLs of less than 2 cm were enrolled and underwent bronchoscopy. An EBUS probe with a guide sheath was inserted through the working channel into the target bronchus. After demonstrated the lesion by ultrasound, EBUS probe was then replaced with biopsy forceps to perform TBLB followed by bronchial brushing. Patients who had negative results were followed. The diagnostic yield was calculated.
RESULTS: Thirty-six patients with the (mean ± SD) PPLs of 1.58 ± 0.3 cm were enrolled. The diagnosis was made by EBUS-GS-guided TBLB in 21 patients (7 benign, 14 malignant). Eight patients were diagnosed by surgical biopsy or bronchoalveolar lavage. The overall diagnostic yield of EBUS-GS-guided TBLB was 58.3% (21/36 patients). Factors influencing the diagnostic yield of EBUS-GS-guided TBLB were the positive CT bronchus sign and EBUS probe located within the lesion. No major complication was observed.
CONCLUSION: EBUS-GS-guided TBLB is a safe procedure and improves the diagnostic yield in peripheral pulmonary lesions size less than 2 cm.
CLINICAL IMPLICATIONS: EBUS-GS-guided TBLB can be used in peripheral pulmonary lesions size less than 2 cm.
DISCLOSURE: Jamsak Tscheikuna, No Financial Disclosure Information; No Product/Research Disclosure Information