0
Pulmonary Procedures |

The Use of Convex-Probe Endobronchial Ultrasound Guided Biopsy in the Diagnosis of Parenchymal Pulmonary Nodules via Segmental Bronchi

Isaac Shalom, MD; Timothy Harkin, MD
Author and Funding Information

Icahn School of Medicine at Mount Sinai Hospital, New York, NY


Chest. 2014;146(4_MeetingAbstracts):742A. doi:10.1378/chest.1990729
Text Size: A A A
Published online

Abstract

SESSION TITLE: EBUS and Advanced Bronchoscopy Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The most common modalities used to diagnose parenchymal lung nodules include bronchoscopic biopsy guided by fluoroscopy, electromagnetic navigation or radial probe endobronchial ultrasound, and also CT-guided needle biopsy and surgical biopsy. The convex-probe endobronchial ultrasound bronchoscope (EBUS) is a well established tool to guide needle aspiration of central thoracic structures that abut the airways, primarily mediastinal and hilar lymph nodes, but also central parenchymal lesions. We report a series of 9 patients in which EBUS was used to accurately locate and guide transbronchial needle aspiration (TBNA) of more peripheral parenchymal pulmonary nodules (PPN) via segmental lower lobe bronchi (SB).

METHODS: Patients who underwent EBUS-TBNA of mediastinal or hilar nodes and also had attempted EBUS guided biopsy of PPN via SB with a convex probe EBUS scope (Olympus BF-UC160F-OL8) were identified by review of procedure logs. Cytology and pathology results, location of PPN, and complications were reviewed. Specimens were designated as adequate if a specific diagnosis was obtained with the EBUS specimen.

RESULTS: Since September 2013, 9 patients received 9 procedures with the intention of obtaining a TBNA of mediastinal or hilar nodes, and visualization of the PPN was attempted during the procedure. 8 PPN in the mid to outer third of the lower lobes were visualized and sampled through SB. One PPN in the outer third of the lung deep in the costophrenic sulcus could not be visualized with EBUS. The patients also underwent standard TBNA of mediastinal lymph nodes. EBUS-TBNA of PPN was adequate in 7/8 procedures, and was suspicious for carcinoma in one additional procedure. In total 5 patients were diagnosed with a malignancy (4 non-small cell lung cancer, 1 metastatic colon cancer) and 2 patients had a benign diagnosis (1 sarcoidosis, 1 MAI). In 4 procedures, EBUS-TBNA of PPN provided the only diagnostic samples. There were no complications attributable to the procedure.

CONCLUSIONS: In our experience, EBUS-TBNA of PPN via SB is a high yield and safe sampling method when the PPN can be visualized. Due to the size and limited flexibility of this bronchoscope, this technique is limited to lower lobe nodules in the mid to outer third of the lung.

CLINICAL IMPLICATIONS: EBUS-TBNA appears to be a useful and safe modality for patients with peripheral pulmonary lesions that may complement the current modalities available, especially in patients who need sampling of intrathoracic lymph nodes.

DISCLOSURE: The following authors have nothing to disclose: Isaac Shalom, Timothy Harkin

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543