Diagnostic Yield and Safety of Endoscopic Ultrasound Guided Fine Needle Aspiration of Central Mediastinal Lung Masses

Abstract EN

Background and Aims.

EUS-FNA is an accurate and safe technique to biopsy mediastinal lymph nodes.

However, there are few data pertaining to the role of EUS-FNA to biopsy central lung masses.

The aim of the study was to assess the diagnostic yield and safety of EUS-FNA of indeterminate central mediastinal lung masses.

Methods.

Design: Retrospective review of a prospectively maintained database; noncomparative.

Setting: Tertiary referral center.

From 10/2004 to 12/2010, all patients with a lung mass located within proximity to the esophagus were referred for EUS-FNA.

Main Outcome Measurement: EUS-FNA diagnostic accuracy and safety.

Results.

73 consecutive patients were included.

EUS allowed detection in 62 (85%) patients with lack of visualization prohibiting FNA in 11 patients.

Among sampled lesions, one patient (1/62 = 1.6%) had a benign lung mass (hamartoma), while the remaining 61 patients (61/62 = 98.4%) had a malignant mass (primary lung cancer: 55/61 = 90%; lung metastasis: 6/61 = 10%).

The sensitivity, specificity, and accuracy of EUS-FNA were 96.7%, 100%, and 96.7%, respectively.

The sensitivity was 80.8% when considering nonvisualized masses.

One patient developed a pneumothorax (1/62 = 1.6%).

Conclusions.

EUS-FNA appears to be an accurate and safe technique for tissue diagnosis of central mediastinal lung masses.