Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of paraesophageal lung tumors - diagnostic yield and added value.

Abstract

There are few data on the use of endoscopic ultrasound (EUS) for the biopsy of suspected malignant lesions of thelung. The main objective of this study was to evaluate the performance of transesophageal EUS fine needle aspiration (EUSFNA)for the diagnosis of paraesophageal lung tumors and also for the confirmation of metastatic sites of lung cancer duringthe same procedure. We performed a retrospective study in a tertiary care unit including 19 patientswith paraesophageal lung tumors referred to our department for a lung biopsy. Transesophageal EUS-FNA was performedusing a linear echoendoscope and 22G needles. In all 19 patients with suspected lung tumors the confirmation of themalignant disease was achieved. Pathological examination revealed 16 cases of non-small cell lung cancers, 2 small cell lungcancers and one case of lung metastases. Diagnostic yield of lung EUS-FNA was 1, with no post-procedural complications. In7 cases, we performed also biopsies of suspected metastasis and all biopsies revealed the same histopathological type as theprimary tumor. Our study supports the use of this minimally invasive technique for paraesophageally locatedlung tumors and demonstrates that EUS-FNA is safe and has an excellent diagnostic yield.