Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions

Ida Skovgaard Christiansen, Jolanda Corina Kuijvenhoven, Uffe Bodtger, Therese Maria Henriette Naur, Khaliq Ahmad, Jatinder Singh Sidhu, Rafi Nessar, Goran Nadir Salih, Asbjørn Høegholm, Jouke Tabe Annema*, Paul Frost Clementsen

*Corresponding author for this work

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Abstract

Background: Diagnosing centrally located lung tumors without endobronchial abnormalities and not located near the major airways is a diagnostic challenge. Tumors near or adjacent to the esophagus can be aspirated and detected with esophageal ultrasound (EUS) using gastrointestinal endoscopes. Objective: To assess the feasibility and diagnostic yield of endoscopic ultrasound with bronchoscope-guided fine needle aspiration (EUS-B-FNA) in paraesophageally located lung tumors and its added value to bronchoscopy and endobronchial ultrasound (EBUS). Methods: Retrospective, multicenter international study (from January 1, 2015 until January 1, 2018) of patients with suspected lung cancer, undergoing bronchoscopy, EBUS, and endoscopic ultrasound bronchoscopy (EUS-B) in one session by a single operator (pulmonologist), in whom the primary lung tumor was detected and aspirated by EUS-B. In the absence of malignancy following endoscopy, transthoracic ultrasound needle aspiration, clinical and radiological follow-up of at least 6 months was performed. The yield and sensitivity of EUS-B-FNA and its added value to bronchoscopy and EBUS was assessed. Results: 58 patients were identified with the following diagnosis: non-small-cell lung cancer (n = 43), small-cell lung cancer (n = 6), mesothelioma (n = 2), metastasis (n = 1), nonmalignant (n = 6). The yield and sensitivity of EUS-B-FNA for detecting lung cancer was 90%. In 26 patients (45%), the intrapulmonary tumor was exclusively detected by EUS-B. Adding EUS-B to conventional bronchoscopy and EBUS increased the diagnostic yield for diagnosing lung cancer in para-esophageally located lung tumors from 51 to 91%. No EUS-B-related complications were observed. Conclusion: EUS-B-FNA is a feasible and safe technique for diagnosing centrally located intrapulmonary tumors that are located near or adjacent to the esophagus. EUS-B should be considered in the same endoscopy session following nondiagnostic bronchoscopy and EBUS.

Original languageEnglish
JournalRespiration
Volume97
Issue number4
Pages (from-to)277-283
ISSN0025-7931
DOIs
Publication statusPublished - 1. Apr 2019

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Bronchoscopes
Lung
Neoplasms
Esophagus
Mesothelioma
Multicenter Studies
Needles
Ultrasonography

Keywords

  • Lung cancer
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Endoscopy, Gastrointestinal
  • Diagnosis
  • outpatient care
  • Multicenter Study
  • Esophageal ultrasound
  • Endobronchial ultrasound

Cite this

Christiansen, I. S., Kuijvenhoven, J. C., Bodtger, U., Naur, T. M. H., Ahmad, K., Singh Sidhu, J., ... Clementsen, P. F. (2019). Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions. Respiration, 97(4), 277-283. https://doi.org/10.1159/000492578
Christiansen, Ida Skovgaard ; Kuijvenhoven, Jolanda Corina ; Bodtger, Uffe ; Naur, Therese Maria Henriette ; Ahmad, Khaliq ; Singh Sidhu, Jatinder ; Nessar, Rafi ; Salih, Goran Nadir ; Høegholm, Asbjørn ; Annema, Jouke Tabe ; Clementsen, Paul Frost. / Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions. In: Respiration. 2019 ; Vol. 97, No. 4. pp. 277-283.
@article{e98e81320e33409c99ee4bd800af8be3,
title = "Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions",
abstract = "Background: Diagnosing centrally located lung tumors without endobronchial abnormalities and not located near the major airways is a diagnostic challenge. Tumors near or adjacent to the esophagus can be aspirated and detected with esophageal ultrasound (EUS) using gastrointestinal endoscopes. Objective: To assess the feasibility and diagnostic yield of endoscopic ultrasound with bronchoscope-guided fine needle aspiration (EUS-B-FNA) in paraesophageally located lung tumors and its added value to bronchoscopy and endobronchial ultrasound (EBUS). Methods: Retrospective, multicenter international study (from January 1, 2015 until January 1, 2018) of patients with suspected lung cancer, undergoing bronchoscopy, EBUS, and endoscopic ultrasound bronchoscopy (EUS-B) in one session by a single operator (pulmonologist), in whom the primary lung tumor was detected and aspirated by EUS-B. In the absence of malignancy following endoscopy, transthoracic ultrasound needle aspiration, clinical and radiological follow-up of at least 6 months was performed. The yield and sensitivity of EUS-B-FNA and its added value to bronchoscopy and EBUS was assessed. Results: 58 patients were identified with the following diagnosis: non-small-cell lung cancer (n = 43), small-cell lung cancer (n = 6), mesothelioma (n = 2), metastasis (n = 1), nonmalignant (n = 6). The yield and sensitivity of EUS-B-FNA for detecting lung cancer was 90{\%}. In 26 patients (45{\%}), the intrapulmonary tumor was exclusively detected by EUS-B. Adding EUS-B to conventional bronchoscopy and EBUS increased the diagnostic yield for diagnosing lung cancer in para-esophageally located lung tumors from 51 to 91{\%}. No EUS-B-related complications were observed. Conclusion: EUS-B-FNA is a feasible and safe technique for diagnosing centrally located intrapulmonary tumors that are located near or adjacent to the esophagus. EUS-B should be considered in the same endoscopy session following nondiagnostic bronchoscopy and EBUS.",
keywords = "Lung cancer, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Endoscopy, Gastrointestinal, Diagnosis, outpatient care, Multicenter Study, Esophageal ultrasound, Endobronchial ultrasound",
author = "Christiansen, {Ida Skovgaard} and Kuijvenhoven, {Jolanda Corina} and Uffe Bodtger and Naur, {Therese Maria Henriette} and Khaliq Ahmad and {Singh Sidhu}, Jatinder and Rafi Nessar and Salih, {Goran Nadir} and Asbj{\o}rn H{\o}egholm and Annema, {Jouke Tabe} and Clementsen, {Paul Frost}",
year = "2019",
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language = "English",
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journal = "Respiration",
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number = "4",

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Christiansen, IS, Kuijvenhoven, JC, Bodtger, U, Naur, TMH, Ahmad, K, Singh Sidhu, J, Nessar, R, Salih, GN, Høegholm, A, Annema, JT & Clementsen, PF 2019, 'Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions', Respiration, vol. 97, no. 4, pp. 277-283. https://doi.org/10.1159/000492578

Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions. / Christiansen, Ida Skovgaard; Kuijvenhoven, Jolanda Corina; Bodtger, Uffe; Naur, Therese Maria Henriette; Ahmad, Khaliq; Singh Sidhu, Jatinder; Nessar, Rafi; Salih, Goran Nadir; Høegholm, Asbjørn; Annema, Jouke Tabe; Clementsen, Paul Frost.

In: Respiration, Vol. 97, No. 4, 01.04.2019, p. 277-283.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions

AU - Christiansen, Ida Skovgaard

AU - Kuijvenhoven, Jolanda Corina

AU - Bodtger, Uffe

AU - Naur, Therese Maria Henriette

AU - Ahmad, Khaliq

AU - Singh Sidhu, Jatinder

AU - Nessar, Rafi

AU - Salih, Goran Nadir

AU - Høegholm, Asbjørn

AU - Annema, Jouke Tabe

AU - Clementsen, Paul Frost

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background: Diagnosing centrally located lung tumors without endobronchial abnormalities and not located near the major airways is a diagnostic challenge. Tumors near or adjacent to the esophagus can be aspirated and detected with esophageal ultrasound (EUS) using gastrointestinal endoscopes. Objective: To assess the feasibility and diagnostic yield of endoscopic ultrasound with bronchoscope-guided fine needle aspiration (EUS-B-FNA) in paraesophageally located lung tumors and its added value to bronchoscopy and endobronchial ultrasound (EBUS). Methods: Retrospective, multicenter international study (from January 1, 2015 until January 1, 2018) of patients with suspected lung cancer, undergoing bronchoscopy, EBUS, and endoscopic ultrasound bronchoscopy (EUS-B) in one session by a single operator (pulmonologist), in whom the primary lung tumor was detected and aspirated by EUS-B. In the absence of malignancy following endoscopy, transthoracic ultrasound needle aspiration, clinical and radiological follow-up of at least 6 months was performed. The yield and sensitivity of EUS-B-FNA and its added value to bronchoscopy and EBUS was assessed. Results: 58 patients were identified with the following diagnosis: non-small-cell lung cancer (n = 43), small-cell lung cancer (n = 6), mesothelioma (n = 2), metastasis (n = 1), nonmalignant (n = 6). The yield and sensitivity of EUS-B-FNA for detecting lung cancer was 90%. In 26 patients (45%), the intrapulmonary tumor was exclusively detected by EUS-B. Adding EUS-B to conventional bronchoscopy and EBUS increased the diagnostic yield for diagnosing lung cancer in para-esophageally located lung tumors from 51 to 91%. No EUS-B-related complications were observed. Conclusion: EUS-B-FNA is a feasible and safe technique for diagnosing centrally located intrapulmonary tumors that are located near or adjacent to the esophagus. EUS-B should be considered in the same endoscopy session following nondiagnostic bronchoscopy and EBUS.

AB - Background: Diagnosing centrally located lung tumors without endobronchial abnormalities and not located near the major airways is a diagnostic challenge. Tumors near or adjacent to the esophagus can be aspirated and detected with esophageal ultrasound (EUS) using gastrointestinal endoscopes. Objective: To assess the feasibility and diagnostic yield of endoscopic ultrasound with bronchoscope-guided fine needle aspiration (EUS-B-FNA) in paraesophageally located lung tumors and its added value to bronchoscopy and endobronchial ultrasound (EBUS). Methods: Retrospective, multicenter international study (from January 1, 2015 until January 1, 2018) of patients with suspected lung cancer, undergoing bronchoscopy, EBUS, and endoscopic ultrasound bronchoscopy (EUS-B) in one session by a single operator (pulmonologist), in whom the primary lung tumor was detected and aspirated by EUS-B. In the absence of malignancy following endoscopy, transthoracic ultrasound needle aspiration, clinical and radiological follow-up of at least 6 months was performed. The yield and sensitivity of EUS-B-FNA and its added value to bronchoscopy and EBUS was assessed. Results: 58 patients were identified with the following diagnosis: non-small-cell lung cancer (n = 43), small-cell lung cancer (n = 6), mesothelioma (n = 2), metastasis (n = 1), nonmalignant (n = 6). The yield and sensitivity of EUS-B-FNA for detecting lung cancer was 90%. In 26 patients (45%), the intrapulmonary tumor was exclusively detected by EUS-B. Adding EUS-B to conventional bronchoscopy and EBUS increased the diagnostic yield for diagnosing lung cancer in para-esophageally located lung tumors from 51 to 91%. No EUS-B-related complications were observed. Conclusion: EUS-B-FNA is a feasible and safe technique for diagnosing centrally located intrapulmonary tumors that are located near or adjacent to the esophagus. EUS-B should be considered in the same endoscopy session following nondiagnostic bronchoscopy and EBUS.

KW - Lung cancer

KW - Endoscopic Ultrasound-Guided Fine Needle Aspiration

KW - Endoscopy, Gastrointestinal

KW - Diagnosis

KW - outpatient care

KW - Multicenter Study

KW - Esophageal ultrasound

KW - Endobronchial ultrasound

U2 - 10.1159/000492578

DO - 10.1159/000492578

M3 - Journal article

C2 - 30253411

AN - SCOPUS:85054166781

VL - 97

SP - 277

EP - 283

JO - Respiration

JF - Respiration

SN - 0025-7931

IS - 4

ER -