BACKGROUND: Obtaining tissue from a para-aortal lymph node or tumor is a challenge that currently requires invasive surgical procedures. Para-aortic lung tumors can be clearly visualized by EUS. Although the accessibility of lesions adjacent to the esophagus is well documented, the para-aortic region has never been systematically explored. OBJECTIVE: To assess the feasibility, yield, and safety of transaortic biopsy specimens in the diagnosis of lung tumors and nodal masses located lateral to the aorta. DESIGN: A retrospective case series of 14 consecutive patients. SETTING: Pulmonary Department, Leiden University Medical Center, Leiden, The Netherlands. PATIENTS: Fourteen patients with known or suspected lung cancer. Nine patients presented with a left-sided lung mass (mean size 27 mm), whereas 5 patients had an enlarged para-aortic node (mean size 16 mm). INTERVENTIONS: Real-time EUS-guided transaortic biopsy of a para-aortic lesion. MAIN OUTCOME MEASUREMENTS: Feasibility, diagnostic yield, and complication rates of transaortic EUS-guided FNA (EUS-FNA). RESULTS: The final diagnosis was known in 12 patients (10 non-small-cell lung carcinoma [NSCLC], 1 small-cell lung carcinoma [SCLC], and 1 renal-cell carcinoma). EUS-FNA established malignancy in 9 of 14 patients (64%) (8 NSCLC and 1 SCLC). One aspirate revealed reactive nodal tissue, and 4 demonstrated nonrepresentative material. Malignancy was further assessed in 3 patients after subsequent diagnostics. Transaortic FNA was found to be safe. In 2 patients, EUS images after biopsy were suspicious for a small para-aortic hematoma. These patients recovered uneventfully. CONCLUSIONS: These results demonstrate that a single EUS-guided transaortic biopsy of para-aortic lymph nodes and tumors is a feasible and probably safe method that results in a diagnosis in the majority of cases.
BACKGROUND: Obtaining tissue from a para-aortal lymph node or tumor is a challenge that currently requires invasive surgical procedures. Para-aortic lung tumors can be clearly visualized by EUS. Although the accessibility of lesions adjacent to the esophagus is well documented, the para-aortic region has never been systematically explored. OBJECTIVE: To assess the feasibility, yield, and safety of transaortic biopsy specimens in the diagnosis of lung tumors and nodal masses located lateral to the aorta. DESIGN: A retrospective case series of 14 consecutive patients. SETTING: Pulmonary Department, Leiden University Medical Center, Leiden, The Netherlands. PATIENTS: Fourteen patients with known or suspected lung cancer. Nine patients presented with a left-sided lung mass (mean size 27 mm), whereas 5 patients had an enlarged para-aortic node (mean size 16 mm). INTERVENTIONS: Real-time EUS-guided transaortic biopsy of a para-aortic lesion. MAIN OUTCOME MEASUREMENTS: Feasibility, diagnostic yield, and complication rates of transaortic EUS-guided FNA (EUS-FNA). RESULTS: The final diagnosis was known in 12 patients (10 non-small-cell lung carcinoma [NSCLC], 1 small-cell lung carcinoma [SCLC], and 1 renal-cell carcinoma). EUS-FNA established malignancy in 9 of 14 patients (64%) (8 NSCLC and 1 SCLC). One aspirate revealed reactive nodal tissue, and 4 demonstrated nonrepresentative material. Malignancy was further assessed in 3 patients after subsequent diagnostics. Transaortic FNA was found to be safe. In 2 patients, EUS images after biopsy were suspicious for a small para-aortic hematoma. These patients recovered uneventfully. CONCLUSIONS: These results demonstrate that a single EUS-guided transaortic biopsy of para-aortic lymph nodes and tumors is a feasible and probably safe method that results in a diagnosis in the majority of cases.
Authors: Christian Jenssen; Jouke Tabe Annema; Paul Clementsen; Xin-Wu Cui; Mathias Maximilian Borst; Christoph Frank Dietrich Journal: J Thorac Dis Date: 2015-10 Impact factor: 2.895
Authors: Christian Jenssen; Maria Victoria Alvarez-Sánchez; Bertrand Napoléon; Siegbert Faiss Journal: World J Gastroenterol Date: 2012-09-14 Impact factor: 5.742
Authors: Albert Garcia-Sumalla; Jose C Subtil; Carlos de la Serna; Sandra Maisterra; Jose Ramon Aparicio; Alejandro Enrique Bojorquez; Rafael Leon Montañes; Enrique Vazquez-Sequeiros; Joan B Gornals Journal: Endosc Int Open Date: 2020-11-27
Authors: Hussein Hassan Okasha; Ahmed El-Meligui; Katarzyna M Pawlak; Michał Żorniak; Hassan Atalla; Amr Abou-Elmagd; Sameh Abou-Elenen; Ramy El-Husseiny; Ahmed Alzamzamy Journal: Endosc Ultrasound Date: 2021 Nov-Dec Impact factor: 5.628