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Abstract: Poster Presentations |

WHICH AREA IN A METASTATIC LYMPH NODE OF LUNG CANCER SHOULD WE PUNCTURE BY ENDOBRONCHIAL ULTRASONOGRAPHY GUIDED TRANSBRONCHIAL NEEDLE ASPIRATION? FREE TO VIEW

Noriaki Kurimoto, MD*; Hiroaki Osada, MD; Teruomi Miyazawa, MD; Yuka Miyazu, MD; Atsuko Ishida, MD
Author and Funding Information

St. Marianna University, Kawasaki, Japan


Chest


Chest. 2005;128(4_MeetingAbstracts):323S-c-324S. doi:10.1378/chest.128.4_MeetingAbstracts.323S-c
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Abstract

PURPOSE:  To assess the location of cancer cells in a metastatic lymph node from lung cancer for endobronchial ultrasonography guided transbronchial needle aspiration (EBUS-TBNA).

METHODS:  We checked 124 metastatic lymph nodes (LNs), which were resected at the operation, histopathologically. We classified 124 metastatic LNs into 3 major stages and 3 sub-stages. Stage I: early stage: stage Ia (marginal stage: metastasis located in the marginal area, the width of the metastasis is less than 1/4 of the width of the LN), stage Ib (marginal invasive stage: metastasis located in the marginal area, the width of the metastasis is less than 1/2 of the width of the LN), stage Ic (central stage: metastasis located in the central area, the width of the metastasis is less than 1/2 of the width of the LN), Stage II: invasive stage (metastasis advanced beyond the center of the LN, the width of the metastasis is greater than 1/2 and less than 9/10 of the width of the LN), Stage III: advanced stage (the width of the metastasis is greater than 9/10 of the width of the LN).

RESULTS:  In 124 LNs, Stage I had 37 LNs (29%), Stage II had 16 LNs (13%), and Stage III had 75 LNs (58%). In 79 LNs which width was greater than 5 mm, Stage I had 16 LNs (20%). There was no LN of Stage Ic in 124 LNs. In 72 LNs of adenocarcinoma, Stage I, II, III had 32%, 6%, and 62%, respectively. In 44 LNs of squamous cell carcinoma, Stage I, II, III had 27%, 27%, and 46%, respectively. In 12 LNs of small cell carcinoma, Stage I, II, III had 25%, 50%, and 25%, respectively.

CONCLUSION:  Metastasis existed in marginal area, not beyond the center of the LN, in 20-29% (Stage Ia+Ib) LNs of total LNs. We should puncture the marginal area of metastatic LNs by EBUS-TBNA.

CLINICAL IMPLICATIONS:  It is necessary to study the yield of TBNA with the puncture in the ceter area vs.marginal area.

DISCLOSURE:  Noriaki Kurimoto, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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