EUS-assisted lung disease evaluation – A Portuguese single centre 9-year experience

Abstract

Ultrasound imaging, especially endosonography, has proven to be valuable in Pulmonology for diagnostic and therapeutic decision purposes. Tissue sampling of mediastinal lesions increases diagnostic accuracy, which is useful in lung cancer diagnosis and staging, study of inflammatory and infectious conditions.

The aim of this study was to evaluate the utility of endoscopic ultrasound (EUS) in evaluating respiratory disease.

The patients (pts) who underwent EUS for respiratory disease diagnosis in our centre since July/2007 were analysed.

81 pts were assessed - 55 male (68%), aged 24-83y (x [x-bar] 63), 26 current smokers (32%) and 18 former smokers (22%).

Oncologic disease was the most frequent diagnostic hypothesis (73%), followed by adenopathy with unreferred aetiological suspicion (17%), sarcoidosis (6%) and infection (4%). 48 pts were submitted to prior exams - 43 of which (89.6%) underwent bronchofibroscopy.

In 63 pts (78%) a diagnosis was obtained. In the remaining 18 cases the lack of diagnostic conclusion was due to insufficient cellular material (33%), inconclusive histological results (39%), inaccessible lesions (17%) or non-performance of biopsy because of benign aspect of adenopathy (11%). The most common diagnosis were lung adenocarcinoma (28%), benign reactive adenomegaly (14%), sarcoidosis (14%), epidermoid lung cancer (11%) and small-cell lung cancer (9,5%). Complications occurred in 1 pt (1,23%) - non-fatal sepsis.

This study supports the importance of EUS in evaluating mediastinal lesions, which is valuable in lung cancer histologic diagnosis and staging, inflammatory and infectious pulmonary diseases. It underlines both the significant diagnostic accuracy and safety of this technique.