Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in the Diagnosis of Intrathoracic Metastasis from Extrapulmonary Malignancy
10.3779/j.issn.1009-3419.2015.05.07
- VernacularTitle:气管内超声引导下经支气管针吸活检在肺外肿瘤胸内转移中的诊断价值
- Author:
SUN JIAYUAN
1
;
BAO LIANG
;
TENG JIAJUN
;
ZHONG RUNBO
;
WENG WEIQIONG
;
ZHANG QIN
;
HAN BAOHUI
Author Information
1. 上海交通大学附属胸科医院内镜室
- Keywords:
Extrapulmonary neoplasm;
Endobronchial ultrasound;
Needle aspiration;
Immunohistochemistry
- From:
Chinese Journal of Lung Cancer
2015;(5):295-300
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been widely applied in diagnosing mediastinal and hilar adenopathy. hTis study is further to evaluate value and safety of EBUS-TBNA in diagnosing intrathoracic metastasis from extrapulmonary malignancy. Methods Prospectively analysis of 41 patients suspected intrathoracic metastasis from previous diagnosed/concurrent extrapulmonary malignancies in Shanghai Chest Hospital, with radiologic ifndings showing mediastinal/hilar lymph node enlargement or intrapulmonary lesion requiring EBUS-TBNA examination for pathological diagnosis. Results 41 candidate patients enrolled, and 67 mediastinal/hilar lymph nodes and 5 intrapulmonary lesions were aspirated. 14 intrathoracic metastasis, 10 primary lung cancer, 9 reactive lymphadenitis, 4 sarcoid-like reactions, and 1 tuberculosis was diagnosed by EBUS-TBNA. Sensitivity and accuracy of EBUS-TBNA in diagnosing intra-thoracic metastasis was 87.50%and 95.12%, respectively. Immunohistochemistry (IHC) was performed in 18 malignant tumors to obtain deifnite type or origin, twelve intrathoracic metastasis and 6 primary lung cancer were further conifrmed. Conclusion EBUS-TBNA is a safe, effective method for the diagnosis of intrathoracic metastasis from extrapulmonary malignancy. IHC can provide additional evidence for distinguishing extrapulmonary malignancy from primary lung cancer.
