Development of new methods to improve the diagnosis of solid lesions including lymph nodes in the mediastinum is desirable. We want to report our preliminary experience with a new method of endoscopic transbronchial ultrasonography with direct, real time guided fine needle aspiration biopsy.
EBUS-FNA was performed in 11 patients, 7 males and 4 females, mean age 58 years. The selection of the patients was based on CT findings in 10 patients and on positron electron tomography (PET) in one patient. The ultrasonic bronchoscope was a prototype, outer diameter 6.7 mm, working length is 550 mm. The instrument has a small curved array transducer located at the distal end in front of a 30 degree oblique forward viewing optic lens and a biopsy channel of 2 mm. The procedure was performed in general anesthesia. The ultrasonic bronchoscope was introduced via the endotracheal tube. EBUS-FNA was performed by direct transducer contact with the trachea or main bronchi with a prototype 22 gauge needle.
A total of 14 lesions were punctured in 11 patients. No complications were experienced. Four lesions were targeted in region 10L, 4 in region 10R, one in region 4L, 2 in region 4R, one in region 1, one in region 7 and one in region 2R. The size of the lesions ranged from 7–80 mm. EBUS-FNA demonstrated malignant cells in 12 lesions and benign cells in 2 lesions.
EBUS-FNA seems promising for lymph node staging of lung cancer as well as for primary diagnosis of solid lesions located adjacent to the main bronchi and the trachea. More experience and further studies are needed in order to evaluate the value of this met
EBUS-FNA in combination with EUS will probably result in a more accurate staging of lung cancer than mediastinoscopy
M. Krasnik, None.