Abstract
Introduction: Diagnostic yield of bronchoscopy for peripheral pulmonary lesions (PPLs) has improved since the application of radial endobronchial ultrasound (R-EBUS). The obtained EBUS image is known to relate the diagnostic yield. However, we sometimes fail to diagnose even if we get the EBUS within image. So we attempted to find out the factors that are difficult to diagnose for these cases.
Materials and Methods: Consecutive patients who underwent bronchoscopy with R-EBUS for PPL in 2013 were collected. The cases that EBUS within image was obtained and finally malignant tumor was proven were enrolled. Each transbronchial biopsy results were checked and the biopsy success rates were calculated. And the cases were divided into the following groups; a) easy group: equal and more than one-third of biopsies were success to prove malignancy, b) difficult group: less than one-third of biopsies were success. We compared factors likely to affect the biopsy success rate between the two groups.
Results: Total 206 malignant tumors were enrolled and the diagnostic yield of bronchoscopy was 86.4 %. Meanwhile, total 1108 transbronchial biopsies were performed and 656 were success to prove malignancy (59.2 %). The biopsies were found to be significantly easier in PPLs with spiculation (p = 0.018) and in PPLs with stenosed bronchi (p = 0.028). These findings indicated that highly invasive tumor had the tendency to expose more to the involved bronchus.
Conclusion: In addition to the reachability to the involved bronchus, we should take care that the invasion findings of PPLs.
- Copyright ©ERS 2015
