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

Aims: There are few data on the use of endoscopic ultrasound (EUS) for the biopsy of suspected malignant lesions of the lung. 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 during the same procedure. Material and methods: We performed a retrospective study in a tertiary care unit including 19 patients with paraesophageal lung tumors referred to our department for a lung biopsy. Transesophageal EUS-FNA was performed using a linear echoendoscope and 22G needles. Results: In all 19 patients with suspected lung tumors the confirmation of the malignant disease was achieved. Pathological examination revealed 16 cases of non-small cell lung cancers, 2 small cell lung cancers and one case of lung metastases. Diagnostic yield of lung EUS-FNA was 1, with no post-procedural complications. In 7 cases, we performed also biopsies of suspected metastasis and all biopsies revealed the same histopathological type as the primary tumor. Conclusions: Our study supports the use of this minimally invasive technique for paraesophageally located lung tumors and demonstrates that EUS-FNA is safe and has an excellent diagnostic yield.