Pulmonary Procedures |

Linear Ultrasonic Bronchoscope for the Transesophageal Assessment of Mediastinal or Pleuropulmonary Pathology: Additional Diagnostic Yield FREE TO VIEW

Carmen Centeno Clemente, MD; Felipe Andreo, MD; Zoran Stojanovic, MD; Jose Sanz, MD; Gloria Bonet, MD; Pere Serra, MD; Mariona Llatjòs, MD; Joan Ruiz, MD
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Germans Trias i Pujol, Badalona, Spain

Chest. 2014;145(3_MeetingAbstracts):500A. doi:10.1378/chest.1823830
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SESSION TITLE: Bronchoscopy & Interventional Procedures

SESSION TYPE: Slide Presentations

PRESENTED ON: Monday, March 24, 2014 at 09:00 AM - 10:30 AM

PURPOSE: To evaluate the role of transesophageal endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) in patients with mediastinal or paramediastinal lesions.

METHODS: Prospective study which included 279 consecutive patients (221 men; mean age 63, SD 13.08), referred to realize EBUS-TBNA, during a 20 months period. Cases that needed substituting or complementing the EBUS-TBNA for EUS-B-FNA were registered. In all the cases with previously realized EBUS-TBNA, cytological samples “in situ” were evaluated before realizing additional transesophageal exploration.

RESULTS: In 50 patients (17.9%) EUS-B-FNA was performed. In 4 cases indication for the procedure was completing the staging, in 9 cases was EBUS intolerance, 20 had inaccessible lesions or technical difficulties for EBUS-TBNA and 17 for being contraindicated or with high risk. A total of 77 lesions were punctured (range 4,2-48,9mm): 3 pulmonary left sided apical masses, 1 subaortic, 1 in the upper right lobe, 3 mediastinal masses, 1 pleural and 68 lymph nodes. In 26 cases (52%) additional diagnostic results were obtained (23 cytological and/or microbiological, 1 for immunohistochemistry and 2 molecular), which supposed 9.3% improvement compared to all of the realized procedures, and 17.3% (26/150) of diagnostic examinations. No complications were observed.

CONCLUSIONS: The EUS-B-FNA is a feasible technique, which can be an alternative or complementary procedure and can improve the diagnostic yield. In our experience it was necessary in at less than one fifth of the cases. Project financed by SEPAR 2010 grant.

CLINICAL IMPLICATIONS: Optimize the study and diagnosis of mediastinal and paramediastinal lesions.

DISCLOSURE: The following authors have nothing to disclose: Carmen Centeno Clemente, Felipe Andreo, Zoran Stojanovic, Jose Sanz, Gloria Bonet, Pere Serra, Mariona Llatjòs, Joan Ruiz

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