PT  - JOURNAL ARTICLE
AU  - Masahide Oki
AU  - Hideo Saka
AU  - Chiyoe Kitagawa
AU  - Yoshihito Kogure
AU  - Saori Oka
AU  - Masashi Nakahata
AU  - Kazumi Hori
AU  - Yuko Ise
AU  - Yasushi Murakami
TI  - Utility of EUS-B-FNA for the diagnosis of EBUS-TBNA inaccessible intrathoracic lesions
AID  - 10.1183/13993003.congress-2016.PA2031
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA2031
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA2031.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA2031.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Introduction: Several studies have reported the usefulness of EUS-B-FNA for staging purposes, but only a few have reported its usefulness for diagnostic purposes.Aims: The purpose of the present study was to evaluate the efficacy of EUS-B-FNA by pulmonologists for the diagnosis of EBUS-TBNA inaccessible intrathoracic lesions.Methods: From March 2009 to December 2015, EUS-B-FNA was performed by pulmonologists in 334 patients at Nagoya Medical Center. One hundred and thirty-nine patients with EUS-B-FNA for staging purposes were excluded, and thus, 195 patients for diagnostic purposes were retrospectively reviewed.Results: A total of 283 lesions (median lesion size in the shortest diameter, 15.3 mm; range 4.4-76.8 mm) in the 195 patients were examined by EUS-B-FNA for diagnostic purposes. The overall diagnostic yield of EUS-B-FNA was 82% (160 of 195). In the 26 patients with prior nondiagnostic bronchoscopy, 18 (69%) were diagnosed by EUS-B-FNA. Moreover, EUS-B-FNA provided diagnostic results in 22 of 33 EBUS-TBNA inaccessible lesions (67%: subaortic region in 3, lower paraesophageal region in 6, vertebral/paravertebral region in 6, left upper lobe in 5, left lower lobe in 1, right upper lobe in 1) that were located apart from the central airway, and in 185 of 250 EBUS-TBNA accessible lesions (74%) located adjacent to the central airway (p = 0.37). EUS-B-FNA was also diagnostic in 7 patients whose condition was inappropriate for bronchoscopy because of respiratory insufficiency or tracheal stenosis.Conclusion: EUS-B-FNA provides high diagnostic yield for patients with lesions difficult to diagnose by EBUS-TBNA, so pulmonologists can enhance the diagnostic yield by acquiring this technique.