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Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of intrapulmonary lesions

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Author:
No author available
Journal Title:
Chinese Journal of Tuberculosis and Respiratory Diseases
Issue:
1
DOI:
10.3760/cma.j.issn.1001-0939.2013.01.009
Key Word:
肺肿瘤;免疫组织化学;活组织检查,针吸;Lung neoplasm;Immunohistochemistry;Biopsy,needle

Abstract: Objective To evaluate real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of intrapulmonary lesions.Methods From October 2009 to November 2011,EBUS-TBNA was performed in 78 patients with paratrachial or parabronchial intrapulmonary lesions proved by CT scan.On-site cytological evaluation was not performed.Immunohistochemistry was applied to distinguish the type of malignant tumor when necessary.Results Sixty-five malignancies and 13 benign diseases were finally diagnosed in 78 intrapulmonary lesions,of which 62 malignancies and 13 benign diseases were distinguished by EBUS-TBNA,including 61 primary lung cancer (adenocarcinoma 36,squamous carcinoma 8,poorly-differentiated carcinoma 5,unknown type carcinoma 3,small cell carcinoma 9),one metastatic lung cancer,7 pulmonary inflammation,5 pulmonary tuberculosis and one fibrosis.There were 3 false negative cases which were diagnosed as pulmonary poorly-differentiated carcinoma,pulmonary sarcomatoid carcinoma and pulmonary lymphoma,respectively.Sensitivity,specificity,positive predictive value,negative predictive value and accuracy of EBUS-TBNA in distinguishing malignant from benign thoracic lesions was 95%,100%,81%,100%,96%,respectively.Immunohistochemistry was performed in 8 malignant tumors without definite type or origin,5 primary lung cancer and one metastatic lung adenocarcinoma were further confirmed.Moderate bleeding from the puncture site during needle aspiration forming blood clot and obstructing the central airway was noted in 1 hy-percoagulable subject.Conclusions EBUS-TBNA is a minimally invasive,safe procedure with high sensitivity for distinguishing malignant from benign lesions.Immunohistochemistry can provide evidence for the definitive diagnosis of malignant lesions.

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