Endobronchial Ultrasonography guided Transbronchial Needle Aspiration (EBUS-TBNA) is used for the lesions around the trachea, main bronchus, or intermediate trunk. We assessed the feasibility of EBUS-TBNA at the lobar, segmental, or sub-segmental bronchus.
EBUS was performed for ten lesions around the lobar, segmental, or sub-segmental bronchus.Before bronchoscopy, we measured the mean diameter of the bronchus just beside the target lesion by ZAIO workstation. In the procedure of EBUS-TBNA, we inserted BF-UC260F (diameter: 6.9 mm, 7.5 MHz, convex type, Olympus) into the lobar, segmental, or sub-segmental bronchus around the target lesion. While scanning the lesion by EBUS, TBNA was performed. Specimens were evaluated cytologically and histopathology.
Case 1(diagnosis; signet ring cell carcinoma): target lesion; #12 lymph node (LN), location of the convex probe; right middle bronchus (mean diameter; 5.5 mm)Case 2 (squamous cell carcinoma): #13 LN, right B10 (mean diameter; 4.5 mm)Case 3 (capillary hemangioma): tumor, right B9+10 (mean diameter; 4.5 mm)Case 4 (tuberculosis): lung lesion, right B7 (mean diameter; 4.9 mm) Case 5 (metastatic tumor from renal cell carcinoma): lung tumor, right B3 (mean diameter; 4.7 mm) Case 6 (adenocarcinoma): lung tumor, right B3 (mean diameter; 4.6 mm) Case 7 (adenocarcinoma): lung tumor, right B10 (mean diameter; 4.6 mm) Case 8 (small cell carcinoma): lung tumor, left B8a (mean diameter; 5.0 mm) Case 9 (adenocarcinoma): #12 LN, right middle bronchus (mean diameter; 5.7 mm) Case 10 (unknown): lung lesion, right B10a ii (mean diameter; 3.5 mm) In all lesions, EBUS visualized the target lesion. In case 10, the lesion was visualized at distal site from the probe on the EBUS image, and EBUS-TBNA was unable to be performed. In 8 out of 9 lesions, EBUS-TBNA provided histopathological diagnosis.
While the mean diameter of the bronchus just beside the target lesion is greater than or equal to 4.5 mm, EBUS-TBNA may be performed at the bronchus beside the target lesion.
EBUS-TBNA may be performed at the lobar, segmentai, or subsegmental bronchus beside the target lesion.
Noriaki Kurimoto, No Financial Disclosure Information; No Product/Research Disclosure Information