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Feasibility and Safety of Obtaining Mediastinal and Hilar Lymph Node Core Biopsy Using Three Point 22 Gauge (G) Endoscopic Ultrasound (EUS) Needle
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A7316 - Feasibility and Safety of Obtaining Mediastinal and Hilar Lymph Node Core Biopsy Using Three Point 22 Gauge (G) Endoscopic Ultrasound (EUS) Needle
Author Block: A. Iravani1, S. Ansari2, C. Reddy3; 1Pulmonary and Critical Care Medicine, University of Utah Health Sciences Center, Huntsman Cancer Hospital, Salt Lake City, UT, United States, 2University of Utah, Salt Lake City, UT, United States, 3Pulmonary and Critical Care Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, United States.
Rationale: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the recommended first diagnostic intervention in abnormally enlarged mediastinal and hilar lymph nodes (LN). However, standard flexible fine needle aspiration (FNA) needles may not provide sufficient diagnostic material. Obtaining a core biopsy may improve the diagnostic yield. Our study assessed feasibility and safety of EBUS-TBNA using three-point (endoscopic ultrasound) EUS needles to obtain core biopsy and also looked into the quality of the samples collected. Methods: Enlarged mediastinal and hilar LN were sampled in 15 patients with both three-point 22-G EUS needles as well as standard 22-G EBUS-TBNA needles. Collected core and FNA samples were initially assessed by rapid on-site evaluation (ROSE). Core samples obtained with three-point needles were sent for surgical pathology. Patients were monitored for complications during the procedure and followed up in one week. Results: All samples obtained with three-point EUS needle were determined to be core biopsy by surgical pathology. In 5 patients, FNA was either unremarkable or unsatisfactory, but core biopsy revealed non-necrotizing granulomas suggestive of sarcoidosis. Core biopsy also provided more material for molecular profiling in patients with primary lung cancer. The three-point needle samples appeared to have less blood contamination. There was no increased procedure related hemorrhage with three-point 22-G needles. No infectious complications were noted at follow up. Conclusion: Obtaining core biopsy from mediastinal and hilar LNs with 22-G three-point EUS needle appears to be safe with no increase in procedure related complications. The samples were larger and appeared to have less blood contamination. Diagnostic yield may also have been improved with 22-G three-point needles.
Author Block: A. Iravani1, S. Ansari2, C. Reddy3; 1Pulmonary and Critical Care Medicine, University of Utah Health Sciences Center, Huntsman Cancer Hospital, Salt Lake City, UT, United States, 2University of Utah, Salt Lake City, UT, United States, 3Pulmonary and Critical Care Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, United States.
Rationale: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the recommended first diagnostic intervention in abnormally enlarged mediastinal and hilar lymph nodes (LN). However, standard flexible fine needle aspiration (FNA) needles may not provide sufficient diagnostic material. Obtaining a core biopsy may improve the diagnostic yield. Our study assessed feasibility and safety of EBUS-TBNA using three-point (endoscopic ultrasound) EUS needles to obtain core biopsy and also looked into the quality of the samples collected. Methods: Enlarged mediastinal and hilar LN were sampled in 15 patients with both three-point 22-G EUS needles as well as standard 22-G EBUS-TBNA needles. Collected core and FNA samples were initially assessed by rapid on-site evaluation (ROSE). Core samples obtained with three-point needles were sent for surgical pathology. Patients were monitored for complications during the procedure and followed up in one week. Results: All samples obtained with three-point EUS needle were determined to be core biopsy by surgical pathology. In 5 patients, FNA was either unremarkable or unsatisfactory, but core biopsy revealed non-necrotizing granulomas suggestive of sarcoidosis. Core biopsy also provided more material for molecular profiling in patients with primary lung cancer. The three-point needle samples appeared to have less blood contamination. There was no increased procedure related hemorrhage with three-point 22-G needles. No infectious complications were noted at follow up. Conclusion: Obtaining core biopsy from mediastinal and hilar LNs with 22-G three-point EUS needle appears to be safe with no increase in procedure related complications. The samples were larger and appeared to have less blood contamination. Diagnostic yield may also have been improved with 22-G three-point needles.
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