Author/Authors :
Arias, S. Interventional Pulmonology - Division of Pulmonary Medicine and Critical Care - University of Miami Miller School of Medicine, Miami, FL, USA , Liu, Q. H. Department of Respiratory Medicine - Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China , Frimpong, B. Interventional Pulmonology - Division of Pulmonary Medicine and Critical Care - School of Medicine - Johns Hopkins University, USA , Lee, H. Interventional Pulmonology - Division of Pulmonary Medicine and Critical Care - School of Medicine - Johns Hopkins University, USA , Feller-Kopman, D. Interventional Pulmonology - Division of Pulmonary Medicine and Critical Care - School of Medicine - Johns Hopkins University, USA , Yarmus, L. Interventional Pulmonology - Division of Pulmonary Medicine and Critical Care - School of Medicine - Johns Hopkins University, USA , Wang, K. P. Interventional Pulmonology - Division of Pulmonary Medicine and Critical Care - School of Medicine - Johns Hopkins University, USA
Abstract :
Background. Lung cancer is the leading cause of malignancy related mortality in the United States. Accurate staging of NSCLC
influences therapeutic decisions. Transbronchial needle aspiration (TBNA) and endobronchial ultrasound-guided TBNA (EBUSTBNA) has been accepted as a procedure for the diagnosis and staging of lung cancer. The aim of this study is to evaluate the
efficacy and adequacy of TBNA and EBUS-TBNA for sampling of mediastinal adenopathy using the Wang’s eleven lymph node
map stations. Methods. We retrospectively reviewed 99 consecutive cases diagnosed with malignancy by EBUS-TBNA and a series
74 patients evaluated for mediastinal adenopathy or a pulmonary lesion using conventional transbronchial needle aspiration. The
IASLC lymph node map was correlated with Wang’s map. Results. A total of 182 lymph node stations were sampled using EBUSTBNA. 96 were positive for nodal metastasis. A total of four cases of samples taken from station 2R showed malignant cells. From
the 74 cases series using cTBNA 167 nodes were sampled in 222 passes. Lymphoid or malignant tissue was obtained in 67 (91.8%)
cases; 55.1% of the nodes were 1 cm or less. Conclusions. The use of the eleven stations described in Wang’s map to guide TBNA
of the mediastinal nodes allows sampling of radiologically considered nonpathological nodes. These data suggest that Wang’s map
covers the most frequent IASLC nodal stations compromised with metastasis.
Keywords :
Lung Cancer Staging , EBUS-TBNA , Endobronchial Landmarks , Guiding TBNA
