Ida Skovgaard Christiansen1,2, Uffe Bodtger1,2,3, Therese Maria Henriette Naur2,4, Khaliq Ahmad2, Jatinder Singh Sidhu2, Rafi Nessar1, Goran Nadir Salih1, Asbjørn Høegholm2, Jouke Tabe Annema5, Paul Frost Clementsen1,4,6. 1. Unit of Respiratory Medicine, Department of Internal Medicine, Zealand University Hospital, Roskilde, Denmark. 2. Department of Respiratory Medicine, Næstved Hospital, Næstved, Denmark. 3. Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark. 4. Copenhagen Academy for Medical Education and Simulation (CAMES), Capital Region of Denmark, Copenhagen, Denmark. 5. Department of Respiratory Medicine, AMC, Amsterdam University Medical Centers, Amsterdam, The Netherlands, j.t.annema@amc.nl. 6. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: In patients with suspected or proven lung cancer, assessment of regional nodal and distant metastases is key before treatment planning. By introducing the endobronchial ultrasound (EBUS)-guided scope into the esophagus and stomach (EUS-B), liver lesions and celiac nodes can be visualized. To date, the utility of EUS-B in diagnosing liver lesions and retroperitoneal lymph nodes is unknown. OBJECTIVES: To assess the feasibility, safety, and diagnostic yield of sampling of liver lesions and retroperitoneal nodes by EUS-B fine-needle aspiration (FNA) in a lung cancer staging setting. METHOD: Consecutive patients suspected of lung cancer in 2 Danish centers between 1 January 2015 and 31 December 2017 were included retrospectively when a lesion in the liver or a retroperitoneal lymph node was visualized and biopsied with EUS-B-FNA. RESULTS: 23 left liver lobe lesions and 19 retroperitoneal lymph nodes were sampled by EUS-B-FNA. Sensitivity and diagnostic yield of sampled liver lesions were 86 and 83%, respectively. In 19/23 patients, there was a cytopathological diagnosis of malignancy. Sensitivity and diagnostic yield from retroperitoneal lymph node samples were 83 and 63%, respectively. In 10/19 patients, the diagnosis was malignancy. No complications were observed. CONCLUSION: EUS-B-FNA enables safe sampling of left liver lobe lesions and retroperitoneal lymph nodes. EUS-B should be considered as a minimally invasive technique to provide tissue proof of distant metastases lung cancer patients.
BACKGROUND: In patients with suspected or proven lung cancer, assessment of regional nodal and distant metastases is key before treatment planning. By introducing the endobronchial ultrasound (EBUS)-guided scope into the esophagus and stomach (EUS-B), liver lesions and celiac nodes can be visualized. To date, the utility of EUS-B in diagnosing liver lesions and retroperitoneal lymph nodes is unknown. OBJECTIVES: To assess the feasibility, safety, and diagnostic yield of sampling of liver lesions and retroperitoneal nodes by EUS-B fine-needle aspiration (FNA) in a lung cancer staging setting. METHOD: Consecutive patients suspected of lung cancer in 2 Danish centers between 1 January 2015 and 31 December 2017 were included retrospectively when a lesion in the liver or a retroperitoneal lymph node was visualized and biopsied with EUS-B-FNA. RESULTS: 23 left liver lobe lesions and 19 retroperitoneal lymph nodes were sampled by EUS-B-FNA. Sensitivity and diagnostic yield of sampled liver lesions were 86 and 83%, respectively. In 19/23 patients, there was a cytopathological diagnosis of malignancy. Sensitivity and diagnostic yield from retroperitoneal lymph node samples were 83 and 63%, respectively. In 10/19 patients, the diagnosis was malignancy. No complications were observed. CONCLUSION: EUS-B-FNA enables safe sampling of left liver lobe lesions and retroperitoneal lymph nodes. EUS-B should be considered as a minimally invasive technique to provide tissue proof of distant metastases lung cancerpatients.
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: Don C Rockey; Stephen H Caldwell; Zachary D Goodman; Rendon C Nelson; Alastair D Smith Journal: Hepatology Date: 2009-03 Impact factor: 17.425
Authors: Daniël A Korevaar; Sara Colella; René Spijker; Patrick M Bossuyt; Lars Konge; Paul Frost Clementsen; Jouke T Annema Journal: Respiration Date: 2016-12-08 Impact factor: 3.580
Authors: Laurence M M J Crombag; Artur Szlubowski; Jos A Stigt; Olga Schuurbiers; Daniël A Korevaar; Peter I Bonta; Jouke T Annema Journal: Lung Cancer Date: 2017-02-20 Impact factor: 5.705