Background: Thoracic lymph node (LN) metastasis is the determining factor for NSCLC staging. However, enlargement in thoracic LNs, which can be detected by chest computed tomography (CT), may not be adequate for NSCLC staging. This study aimed to investigate the effectiveness of a new transbronchial needle aspiration (TBNA) procedure to improve the sensitivity and accuracy of lung cancer diagnosis and staging.
Methods: A standardized TBNA procedure was performed on enlarged and non-enlarged LNs in the order of N3 to N1 station according to Wang's LN map. The status of LN metastasis determined by the standardized TBNA procedure was compared with the results from CT scan.
Results: The TBNA biopsy revealed that 21.43% of non-enlarged LNs were malignant. Compared with chest CT, the standardized TBNA procedure improved the accuracy of LN metastasis staging and discovered skip LN metastasis.
Conclusions: The standardized TBNA procedure of this study may be recommended to be used as a routine TBNA procedure, in which LNs should be biopsied in the order of N3 to N1 station and both enlarged and non-enlarged LNs should be included to improve the accuracy of lung cancer staging.
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http://dx.doi.org/10.3978/j.issn.2072-1439.2015.11.32 | DOI Listing |
Br J Hosp Med (Lond)
December 2024
Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the standard method for sampling mediastinal/hilar lymph node disease. However, the smaller samples obtained via needle aspiration have a lower diagnostic rate for benign compared to malignant diseases. The low diagnostic rates have been reported to be improved through using endobronchial ultrasound-guided intranodal forceps biopsy (EBUS-IFB), but the implementation of IFB presents technical challenges, as described with variable results in certain studies.
View Article and Find Full Text PDFJ Thorac Dis
December 2024
Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a critical method for diagnosing lung cancer. While EBUS-TBNA is commonly performed under conscious sedation, the potential benefits of conducting the procedure under general anesthesia and incorporating rapid on-site evaluation (ROSE) to enhance diagnostic yield remain uncertain. This study aims to investigate the impact of anesthesia methods and ROSE on the diagnostic efficacy of EBUS-TBNA for lung cancer.
View Article and Find Full Text PDFJ Bronchology Interv Pulmonol
April 2025
Department of Medicine, Division of Respirology, University of Calgary, Calgary, AB.
Background: Diagnosis of sarcoidosis often involves endobronchial biopsy (EBB), but studies have shown varying yields for EBB in suspected sarcoidosis, partly due to differences in identifying abnormal mucosa under white light (WL). Narrow band imaging (NBI) may assist in the visualization of abnormal mucosa, but its role in sarcoidosis remains to be characterized.
Methods: Individuals referred for suspected sarcoidosis were considered for enrollment.
Cureus
December 2024
Internal Medicine, Unidade Local de Saúde do Oeste - Hospital Distrital de Caldas da Rainha, Caldas da Rainha, PRT.
Sarcoidosis is a systemic granulomatous disease of unknown etiology, primarily affecting the lungs and the lymphatic system. Its diagnosis is challenging, and in many cases, it requires histopathological confirmation through the identification of non-caseating granulomas. The presented case illustrates its diagnostic complexity and highlights a rare, delayed complication associated with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).
View Article and Find Full Text PDFMediastinum
December 2024
Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA.
Background And Objective: Diagnosis of pathology in the mediastinum has proven quite challenging, given the wide variability of both benign and malignant diseases that affect a diverse array of structures. This complexity has led to the development of many different non-invasive and invasive diagnostic modalities. Historically, diagnosis of the mediastinum has relied on different imaging modalities such as chest X-ray, computed tomography (CT), magnetic resonance imaging, and positron emission topography.
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