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ORIGINAL RESEARCHINTERVENTIONAL PULMONOLOGYDiagnosis of Peripheral Lung Cancer With Three Echoic Features Via Endobronchial Ultrasound
Section snippets
Study Subjects
The subjects in this study were patients who underwent bronchoscopy and EBUS to assess peripheral lung lesions in Chang Gung Memorial Hospital, Taipei, Taiwan, from June 2004 to July 2005. A total of 1,963 patients received bronchoscopic examinations for various indications during this period. Informed consent was obtained from all the subjects, and this study was approved by the hospital internal review boards. Among the 1,963 patients, 489 underwent EBUS for evaluation because no peripheral
Hisotopathologic Diagnosis of Lesions
Table 1 summarizes the histopathologic data of 224 patients with peripheral lung lesions. Among these 224 patients, 123 had malignant lesions, and 101 had benign lesions. The histopathologic diagnoses for malignant lesions were adenocarcinoma (n = 85), squamous cell carcinoma (n = 38), and small cell carcinoma (n = 14). The diseases found in benign lesions included tuberculosis (n = 23), pneumonia (n = 25), necrotizing pneumonitis (n = 16), anthracotic deposition (n = 11), organizing pneumonia
Discussion
The results of this study indicate that with three simplified image features, including the presence of a continuous margin, the absence of a linear-discrete air bronchogram, and heterogeneous echogenicity of internal structure, EBUS may provide a useful tool for differentiating benign lesions from malignant peripheral lung lesions. The presence of any single EBUS feature yields a positive value for malignancy of 74%. The likelihood of malignancy rises to 89% when the lesion exhibits any two
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The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
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These two authors contributed equally to the work on this project as first authors