Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe procedure used in lymph node staging non-small cell lung cancer. Extrapulmonary malignancies also affect mediastinal and hiliar lymph nodes. The aim of our study was to determine the role of EBUS-TBNA in the diagnosis of an unknown extrapulmonary malignancy and in the staging or relapse of a previous one. Retrospective analysis was performed in 83 patients, 61 patients with known previous extrapulmonary malignancy and 22 patients with unknown primary malignancy. Patients underwent EBUS-TBNA between May 2008 and November 2013. The following data was collected:age, type of previous malignancy, CTscan findings, lymph node station, cytopathological diagnosis, confirmation biopsy and the follow up.
There were 54 male and 29 female with a mean age of 62 years.45 cases had extrathoracic metastasis confirmed by PET/CTscan at the time of performing EBUS-TBNA.We identified 52 (61,9%) cases positive for extrapulmonary tumors, 26 cases negative, 4 cases of lung cancer and 1 case of unknown origin. 19 (36%) of the 52 cases were of unknown primary tumor,7 epithelial tumors and 11 lymphomas. The rest of the positive results (64%) were obtained by evaluating staging or relapse of a known extrapulmonary tumor. The sensitivity, the accurancy and VPN of EBUS-TBNA in diagnosing and staging extrapulmonary tumours were 88,7%, 100% and 73,1%.In our experience EBUS-TBNA can be an initial test for a diagnostic approach of extrapulmonary tumors and staging of known extrapulmonary tumors because of its high sensitivity, accurancy and safety.Consequently it can determine their correct therapeutic management.
- © 2014 ERS