PURPOSE: The aim of the present study was to test the use of EBUS-TBNA and EUS-FNA in patients with an undiagnosed solid lesion of unknown origin in the lung outlined by CT.
METHODS: The combination of EBUS-TBNA and EUS-FNA was prospective performed in 52 patients. 5 patients with a tumour in the mediastinum and 47 with undiagnosed tumour in the lungs. Bronchoscopy and TBNA have been performed in all patients without obtaining a diagnosis.
RESULTS: A total of 5 tumours and 103 lymph nodes were biosied. EBUS TBNA was positive for cancer in 34 lymph nodes and 5 tumours and by EUS poitive for cancer in 5 tumours and 37 patients. In 3 lesions the specimen was without conclusive material.In 31 patients a malignant diagnose was obtained. In 3 patients a specific non malignant diagnose was obtained (sarcoidosis, thymoma and fungal infection). In 20 patients normal lymph cells were obtained. All the diagnosis was confirmed either by mediastinoscopy or Thoracotomy/scopy. The diagnostic yield was 97% (105/108)The diagnose was obtained by EBUS-TBNA in 29 patients and by EUS-FNA in 28 patients. In 3 patients the diagnose was obtained only by EBUS-TBNA and only by EUS in 28 patients In 1 patient both EUS and EBUS were false negative- the malignant diagnose was obtained by puncture of N1 lymph nodes.
CONCLUSION: EBUS-TBNA is an effective and non invasive method to obtain a diagnose in patients with lesions of unknown origin in the mediastinum and hillar regions.
CLINICAL IMPLICATIONS: With the combined use of EBUS- TBNA and EUS-FNA is not only diagnostic but staging is also obtained with the diagnostic procedure.
DISCLOSURE: Mark Krasnik, None.