HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hünerbein, M. Articles by Schlag, P. M. Search for Related Content PubMed PubMed Citation Articles by Hünerbein, M. Articles by Schlag, P. M.

J Thorac Cardiovasc Surg 1998;116:554-559
© 1998 Mosby, Inc.

GENERAL THORACIC SURGERY

Transesophageal biopsy of mediastinal and pulmonary tumors by means of endoscopic ultrasound guidance

Berlin, Germany

From the Charitè University Hospital, Robert Rössle Hospital and Tumor Institute, Humboldt University, Berlin, Germany.

Received for publication Dec 19, 1997. Revisions requested March 17, 1998; revisions received April 23, 1998. Accepted for publication April 24, 1998. Address for reprints: P. M. Schlag, MD, Department of Surgery and Surgical Oncology, Robert-Rössle Hospital and Tumor Institute, Humboldt University, Lindenbergerweg 80, 13122 Berlin, Germany.

Objective: The aim of this study was to investigate the value of endoscopic ultrasound–guided biopsy for the diagnosis of thoracic lesions.
Methods: Transesophageal ultrasound–guided biopsy was performed in 29 patients with mediastinal (n = 25) or pulmonary tumors (n = 4). A flexible echoendoscope with a 7.5 MHz curved array transducer (Pentax FG 32 UA, Hamburg, Germany) and a biopsy device with a fine needle (diameter 0.8 mm) were used for all examinations. Three patients were excluded from the analysis of the data because a definite diagnosis based on surgery or follow-up was not available.
Results: Real-time visualization of the biopsy procedure with endoscopic ultrasound enabled accurate tissue sampling even of small mediastinal lesions with a diameter of less than 1 cm. Diagnostic material was obtained in 23 of the 26 patients (88%). In 3 cases (12%) non-representative biopsy material was found in the specimen. The sensitivity and specificity of transesophageal biopsy in the diagnosis of malignancy were 89% and 83%, respectively. Histologic analysis of the biopsy specimens established malignancy in 17 of 23 patients, whereas benign lesions were diagnosed in 6 patients. Endoscopic ultrasound–guided biopsy confirmed the diagnosis suggested by conventional diagnostic methods in 15 of 23 patients (65%), whereas an unsuspected diagnosis was disclosed in 8 patients (35%). The results of the biopsy had considerable impact on the therapeutic strategy. None of the patients had complications related to the procedure.
Conclusions: Endoscopic ultrasound–guided biopsy provides a new minimally invasive approach to the biopsy of lesions in the posterior mediastinum and may complement surgical staging procedures.

This article has been cited by other articles:

				M. A. Eloubeidi, A. Tamhane, V. K. Chen, and R. J. Cerfolio Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Patients With Non-Small Cell Lung Cancer and Prior Negative Mediastinoscopy Ann. Thorac. Surg., October 1, 2005; 80(4): 1231 - 1239. [Abstract] [Full Text] [PDF]

				M. S. Bhutani, D. V. Jones Jr, and J. B. Zwischenberger Endoscopic Ultrasound-Guided Fine-Needle Aspiration Staging of Lung Cancer: Is It Time To Go Beyond Cytology? Chest, February 1, 2005; 127(2): 418 - 420. [Full Text] [PDF]

				J. K. LeBlanc, B. M. Devereaux, T. F. Imperiale, K. Kesler, J. M. DeWitt, O. Cummings, D. Ciaccia, S. Sherman, P. Mathur, D. Conces, et al. Endoscopic Ultrasound in Non-Small Cell Lung Cancer and Negative Mediastinum on Computed Tomography Am. J. Respir. Crit. Care Med., January 15, 2005; 171(2): 177 - 182. [Abstract] [Full Text] [PDF]

				K. Yasufuku, M. Chiyo, Y. Sekine, P. N. Chhajed, K. Shibuya, T. Iizasa, and T. Fujisawa Real-time Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Mediastinal and Hilar Lymph Nodes Chest, July 1, 2004; 126(1): 122 - 128. [Abstract] [Full Text] [PDF]

				I Penman and R J Fergusson Endoscopic ultrasound: a useful tool to assess the mediastinum in patients with lung cancer? Thorax, February 1, 2002; 57(2): 95 - 96. [Full Text] [PDF]

				S S Larsen, M Krasnik, P Vilmann, G K Jacobsen, J H Pedersen, P Faurschou, and K Folke Endoscopic ultrasound guided biopsy of mediastinal lesions has a major impact on patient management Thorax, February 1, 2002; 57(2): 98 - 103. [Abstract] [Full Text] [PDF]

				M. J. Wiersema, E. Vazquez-Sequeiros, and L. M. Wiersema Evaluation of Mediastinal Lymphadenopathy with Endoscopic US-guided Fine-Needle Aspiration Biopsy Radiology, April 1, 2001; 219(1): 252 - 257. [Abstract] [Full Text]

				P. Biro, M. Layer, H. D. Becker, F. Herth, K. Wiedemann, B. Seifert, and D. R. Spahn Influence of airway-occluding instruments on airway pressure during jet ventilation for rigid bronchoscopy Br. J. Anaesth., September 1, 2000; 85(3): 462 - 465. [Abstract] [Full Text] [PDF]

				M. S. Bhutani Transesophageal Endoscopic Ultrasound-Guided Mediastinal Lymph Node Aspiration : Does the End Justify the Means? Chest, February 1, 2000; 117(2): 298 - 301. [Full Text] [PDF]

				A. Fritscher-Ravens, N. Soehendra, L. Schirrow, P. V. J. Sriram, A. Meyer, H.-P. Hauber, and A. Pforte Role of Transesophageal Endosonography-Guided Fine-Needle Aspiration in the Diagnosis of Lung Cancer Chest, February 1, 2000; 117(2): 339 - 345. [Abstract] [Full Text] [PDF]