Endobronchial mediastinal ultrasound with biopsy

INTRODUCTION: Endobronchial ultrasound (EBUS) is a minimally invasive diagnostic modality, by which it is possible to visualize and do biopsy of structures adjacent to the trachea and the central bronchial system. EBUS is mostly used for staging of lung cancer patients, but EBUS is now used worldwide as a diagnostic tool in patients with mediastinal tumours or adenopathy. MATERIAL AND METHODS: In this paper, we report of the result of the first 100 EBUS patients referred for further investigation of mediastinal adenopathy or tumour found via CT. All 100 patients underwent EBUS in general anaesthesia, and 95 patients had transbronchial needle aspiration biopsy performed (TBNA). RESULTS: A total of 46 patients were known to have or have had cancer; in 20 of these patients we found cancer in the mediastinum by EBUS-TBNA, 24 patients had lymph node aspirates without cancer and in two patients the aspirate was inconclusive. The remaining 49 patients all had a record of non-malignant medical disease; 22 of these patients were found to have cancer in the mediastinum, one patient had cancer-suspect EBUS-TBNA, 24 had lymph node aspirates without malignancy and in two patients the aspirate was inconclusive. All patients were followed for 6-30 months. The sensitivity was roughly calculated to 94%. No patients suffered any complications. CONCLUSION: We conclude that EBUS-TBNA is a safe and accurate diagnostic tool in the evaluation of mediastinum in patients with cancer as well as in patients with non-malignant disease.