Endoscopic ultrasound in the diagnosis of
mediastinal diseases

• Authors: Zhiguo Wang , Chunmeng Jiang
• Languages of publication: EN

Abstracts

EN

EUS is a useful tool for diagnosis of mediastinal
diseases. EUS-FNA plays an important role in staging
of lung cancer and in tissue acquisition in patients with
mediastinal masses. In this review, the following issues
will be addressed: EUS-FNA and EBUS-TBNA, metastatic
mediastinal lymph nodes diagnosed by EUS, EUS in
assessment of mediastinal lymph node status for staging
of lung cancer, mediastinal lymphoma diagnosed by EUS,
sarcoidosis and tuberculosis diagnosed by EUS.

Keywords

EN

EUS; mediastinal diseases

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2014
• Volume: 10
• Issue: 1

Dates

accepted

10 - 11 - 2015

received

18 - 10 - 2015

online

21 - 12 - 2015

Contributors

author

Zhiguo Wang

• The Second Hospital of
  Dalian Medical University, NO.467, Zhongshan Road, 116027 Dalian,
  Liaoning, China

author

Chunmeng Jiang

• The Second Hospital of
  Dalian Medical University, NO.467, Zhongshan Road, 116027 Dalian,
  Liaoning, China

References

• [1] Devereaux BM, Leblanc JK, Yousif E, Kesler K, Brooks J, MathurP, et al. Clinical utility of EUS-guided fine-needle aspirationof mediastinal masses in the absence of known pulmonarymalignancy. Gastrointest Endosc. 2002 Sep;56(3):397-401[Crossref]
• [2] Barawi M, Gress F. EUS-guided fine-needle aspiration in themediastinum. Gastrointest Endosc 2000;52(6 Suppl):12S-17S[Crossref]
• [3] Fuccio L, Larghil A. Endoscopic ultrasound-guided fineneedle aspiration: How to obtain a core biopsy? EndoscopicUltrasound 2014;3:71-81
• [4] Fujii LL, Levy MJ. Basic techniques in endoscopic ultrasoundguidedfine needle aspiration for solid lesions: Adverse eventsand avoiding them. Endoscopic Ultrasound 2014;3:35-45
• [5] Fritscher-Ravens A, Sriram PV, Bobrowski C, Pforte A, TopalidisT, Krause C, et al. Mediastinal lymphadenopathy in patientswith or without previous malignancy: EUS-FNA-baseddifferential cytodiagnosis in 153 patients. Am J Gastroenterol.2000 Sep;95(9):2278-2284[Crossref]
• [6] Savides TJ. EUS for mediastinal disease. Gastrointest Endosc2009;69(2 Suppl):S97-99[Crossref]
• [7] Hebert-Magee S. Basic technique for solid lesions: Cytology,core, or both? Endoscopic Ultrasound 2014;3:28-34
• [8] Eloubeidi MA. Endoscopic ultrasound-guided fine-needleaspiration in the staging and diagnosis of patients with lungcancer. Semin Thorac Cardiovasc Surg 2007;19:206-211[Crossref]
• [9] Savides TJ, Behling CM. EUS for unexplained mediastinallesions. Endoscopy 2006;38(Suppl 1):S73-6[Crossref]
• [10] Yasuda I, Tsurumi H, Omar S, et al. Endoscopic ultrasoundguidedfineneedle aspiration biopsy for lymphadenopathy ofunknown origin. Endoscopy 2006;38:919-924[Crossref]
• [11] Herth FJ, Rabe KF, Gasparini S, Annema JT.et al. Transbronchialand transoesophageal (ultrasound-guided) needle aspirationsfor the analysis of mediastinal lesions. Eur Respir J.2006; 28:1264-1275[Crossref]
• [12] Lachter J. Basic technique in endoscopic ultrasound-guidedfine needle aspiration for solid lesions: What needle is thebest? Endoscopic Ultrasound 2014;3:46-53
• [13] Vilmann P, Larsen SS. Larsen. Endoscopic ultrasound-guidedbiopsy in the chest: little to lose, much to gain. Eur Respir J2005; 25: 400-401[Crossref]
• [14] Panelli F, Erickson RA, Prasad VM. Evaluation of mediastinalmasses by endoscopic ultrasound and endoscopic ultrasoundguidedfine needle aspiration. Am J Gastroenterol. 2001Feb;96(2):401-408[Crossref]
• [15] Arluk GM, Coyle WJ. EUS and fine-needle aspiration in theevaluation of mediastinal masses superior to the aortic arch.Gastrointest Endosc. 2001 Jun;53(7):793-797[Crossref]
• [16] Koh DM, Burke S, Davies N, Padley SP..Transthoracic US of thechest: clinical uses and applications. Radiographics. 2002Jan-Feb;22(1):e1[Crossref]
• [17] Lee YT, Lai LH, Sung JJ, Ko FW, Hui DS. Endoscopic ultrasonography-guided fine-needle aspiration in the management ofmediastinal diseases: local experience of a novel investigation.Hong Kong Med J. 2010 Apr;16(2):121-125
• [18] Ardengh JC, Bammann RH, Giovani Md, Venco F, Parada AA.Endoscopic ultrasound-guided biopsies for mediastinal lesionsand lymph node diagnosis and staging. Clinics (Sao Paulo).2011;66(9):1579-1583
• [19] Manucha V, Kaur G, Verma K. Endoscopic ultrasound-guidedfine needle aspiration (EUS-FNA) of mediastinal lymph nodes:experience from region with high prevalence of tuberculosis.Diagn Cytopathol. 2013 Dec;41(12):1019-22. doi: 10.1002/dc.21698. Epub 2011 Apr 28[Crossref]
• [20] Zeppa P, Barra E, Napolitano V, Cozzolino I, Troncone G,Picardi M, De Renzo A, Mainenti PP, Vetrani A, PalombiniL. Impact of endoscopic ultrasound-guided fine needleaspiration (EUS-FNA) in lymph nodal and mediastinallesions: a multicenter experience. Diagn Cytopathol. 2011Oct;39(10):723-9. doi: 10.1002/dc.21450. Epub 2010 Oct 19[Crossref]
• [21] Serna DL, Aryan HE, Chang KJ, Brenner M, Tran LM, Chen JC.An early comparison between endoscopic ultrasound-guidedfine-needle aspiration and mediastinoscopy for diagnosis ofmediastinal malignancy. Am Surg. 1998 Oct;64(10):1014-1018
• [22] Vilmann P, Krasnik M, Larsen SS, Jacobsen GK, Clementsen P.Transesophageal endoscopic ultrasound-guided fine-needleaspiration (EUS-FNA) and endobronchial ultrasound-guidedtransbronchial needle aspiration (EBUS-TBNA) biopsy: acombined approach in the evaluation of mediastinal lesions.Endoscopy. 2005 Sep;37(9):833-839[Crossref]
• [23] Herth FJ. Mediastinal staging--the role of endobronchial andendo-oesophageaL sonographic guided needle aspiration.Lung Cancer. 2004 Aug;45 Suppl 2:S63-67
• [24] Oki M, Saka H, Ando M, Tsuboi R, Nakahata M, Oka S, KogureY, Kitagawa C. Transbronchial vs transesophageal needleaspiration using an ultrasound bronchoscope for the diagnosisof mediastinal lesions: a randomized study. Chest. 2015May;147(5):1259-66. doi: 10.1378/chest.14-1283[Crossref]
• [25] Herth FJ. Endobronchial ultrasound: First choice for themediastinum. Endoscopic ultrasound. 2013;2(4):179-180
• [26] Herth FJ, Lunn W, Eberhardt R, Becker HD, Ernst A.Transbronchial versus transesophageal ultrasound-guidedaspiration of enlarged mediastinal lymph nodes. Am J RespirCrit Care Med 2005;171:1164-1167[Crossref]
• [27] Vilmann P, Krasnik M, Larsen SS, Jacobsen GK, Clementsen P.Transesophageal endoscopic ultrasound-guided fine-needleaspiration (EUS-FNA) and endobronchial ultrasound-guidedtransbronchial needle aspiration (EBUS-TBNA) biopsy: Acombined approach in the evaluation of mediastinal lesions.Endoscopy 2005;37:833-839[Crossref]
• [28] Savides TJ, Behling CM. EUS for unexplained mediastinallesions. Endoscopy. 2006 Jun;38 Suppl 1:S73-76[Crossref]
• [29] Catalano MF, Nayar R, Gress F, Scheiman J, Wassef W,Rosenblatt ML, et al. EUS-guided fine needle aspirationin mediastinal lymphadenopathy of unknown etiology.Gastrointest Endosc. 2002 Jun;55(7):863-869[Crossref]
• [30] Annema JT, Rabe KF. State of the art lecture: EUS and EBUS inpulmonary medicine. Endoscopy. 2006 Jun;38 Suppl 1:S118-122[Crossref]
• [31] Ishikawa M, Kitayama J, Kaizaki S, Sako A, Nakao K, SugawaraM, et al. Diagnosis of nasopharyngeal carcinoma metastaticto mediastinal lymph nodes by endoscopic ultrasonographyguidedfine-needle aspiration biopsy. Acta Otolaryngol. 2005Sep;125(9):1014-1017[Crossref]
• [32] Agarwal B, Gogia S, Eloubeidi MA, Correa AM, Ho L, Collins BT.Malignant mediastinal lymphadenopathy detected by stagingEUS in patients with pancreaticobiliary cancer. GastrointestEndosc. 2005 Jun;61(7):849-853[Crossref]
• [33] Fritscher-Ravens A, Sriram PV, Topalidis T, Jaeckle S, Thonke F,Soehendra N. Endoscopic ultrasonography-guided fine-needlecytodiagnosis of mediastinal metastases from renal cell cancer.Endoscopy. 2000 Jul;32(7):531-535[Crossref]
• [34] Varghese LR, Stanley MW, Wakely PE Jr, Lucido ML, MalleryS, Bardales RH. A case report of anthracosilicotic spindle-cellpseudotumor of mediastinal lymph node: cytologic diagnosisby endoscopic ultrasound-guided fine-needle aspiration. DiagnCytopathol. 2005 Oct;33(4):268-272[Crossref]
• [35] Varadarajulu S, Schmulewitz N, Wildi SM, Roberts S, RavenelJ, Reed CE, et al. Accuracy of EUS in staging of T4 lung cancer.Gastrointest Endosc. 2004 Mar;59(3):345-348[Crossref]
• [36] Detterbeck FC, Lewis SZ, Diekemper R, Addrizzo-Harris D,Alberts WM. Executive summary: Diagnosis and managementof lung cancer, 3rd ed: American College of Chest physiciansevidence-based clinical practice guidelines. Chest. 2013; 143( 5_suppl ):7S-37S[Crossref]
• [37] Sanchez de Cos J, Hernandez JH, Lopez MF, Sanchez SP,Gratacos AR, Porta RR; Sociedad Espanola Neumologia yCirugia Toracica. SEPAR guidelines for lung cancer staging.Arch Bronconeumol. 2011; 47 ( 9 ): 454-465[Crossref]
• [38] Vansteenkiste J, De Ruysscher D, Eberhardt WE, et al; ESMOGuidelines Working Group. Early and locally advancednon-smallcell lung cancer (NSCLC): ESMO clinical practiceguidelines for diagnosis, treatment and follow-up. Ann Oncol.2013; 24 ( suppl 6 ): vi89-vi98
• [39] National Institute for Health and Care Excellence ClinicalGuideline. 2011. Lung cancer: the diagnosis and treatment oflung cancer. National Institute for Health and Care Excellencewebsite. http:// egap.evidence.nhs.uk/lung-cancer-cg121.Accessed September 23, 2014
• [40] Tomiyama N, Honda O, Tsubamoto M, Inoue A, SumikawaH, Kuriyama K, Kusumoto M, Johkoh T, Nakamura H (2009)Anterior mediastinal tumors: diagnostic accuracy of CT andMRI. Eur J Radiol 69:280-288[Crossref]
• [41] Murgu SD. Diagnosing and staging lung cancer involving themediastinum. Chest. 2015 May;147(5):1401-12. doi: 10.1378/chest.14-1355[Crossref]
• [42] Silvestri GA, Gonzalez AV, Jantz AV, et al. Methods for stagingnon-small cell lung cancer: diagnosis and management of lungcancer, 3rd ed: American College of Chest Physicians evidencebasedclinical practice guidelines. Chest. 2013; 143 ( 5_suppl):e211S-e250S.
• [43] Toloza EM, Harpole L, Detterbeck F, McCrory DC. Invasivestaging of non-small cell lung cancer: a review of the currentevidence. Chest. 2003 Jan;123(1 Suppl):157S-166S[Crossref]
• [44] Detterbeck FC, DeCamp MM Jr, Kohman LJ, Silvestri GA;American College of Chest Physicians. Lung cancer.Invasivestaging:the guidelines. Chest,2003,123(1 Suppl):167S-175S[Crossref]
• [45] Rintoul RC, Skwarski KM, Murchison JT, Wallace WA, Walker WS,Penman ID. Endobronchial and endoscopic ultrasound-guidedreal-time fine-needle aspiration for mediastinal staging. EurRespir J 2005; 25: 416-421[Crossref]
• [46] Kim ES, Bosquée L. The importance of accurate lymph nodestaging in early and locally advanced non-small cell lungcancer: an update on available techniques. J Thorac Oncol.2007 Jun;2 Suppl 2:S59-67[Crossref]
• [47] Colella S, Vilmann P, Konge L, et al. Endoscopic ultrasoundin the diagnosis and staging of lung cancer. EndoscopicUltrasound 2014;3:205-212
• [48] Yasuda I, Tsurumi H, Omar S, Iwashita T, Kojima Y, Yamada T,et al. Endoscopic ultrasound-guided fine-needle aspirationbiopsy for lymphadenopathy of unknown origin. Endoscopy.2006 Sep;38(9):919-924[Crossref]
• [49] Ribeiro A, Vazquez-Sequeiros E, Wiersema LM, Wang KK, ClainJE, Wiersema MJ. EUS-guided fine-needle aspiration combinedwith flow cytometry and in the diagnosis of lymphoma.Gastrointest Endosc. 2001 Apr;53(4):485-491[Crossref]
• [50] Zimmer T, Patan M, Berdel WE, Dulce MC, Riecken EO. Valueof endoscopic ultrasound examination of the mediastinum inHodgkin’s and non-Hodgkin’s lymphomas. Ultraschall Med.1997 Apr;18(2):67-71[Crossref]
• [51] Stacchini A, Carucci P, Pacchioni D, Accinelli G, DemurtasA, Aliberti S, Bosco M, Bruno M, Balbo Mussetto A, RizzettoM, Bussolati G, De Angelis C. Diagnosis of deep-seatedlymphomas by endoscopic ultrasound-guided fine needleaspiration combined with flow cytometry.Cytopathology. 2012Feb;23(1):50-6. doi: 10.1111/j.1365-2303.2010.00842.x. Epub2011 Jan 10[Crossref]
• [52] Ribeiro A, Vazquez-Sequeiros E, Wiersema LM, Wang KK, ClainJE, Wiersema MJ. EUS-guided fine-needle aspiration combinedwith flow cytometry and immunocytochemistry in the diagnosisof lymphoma. Gastrointest Endosc. 2001 Apr;53(4):485-491[Crossref]
• [53] Yasuda I, Tsurumi H, Omar S, Iwashita T, Kojima Y, Yamada T,Sawada M, Takami T, Moriwaki H, Soehendra N. Endoscopicultrasound-guided fine-needle aspiration biopsy forlymphadenopathy of unknown origin. Endoscopy. 2006Sep;38(9):919-924[Crossref]
• [54] Rana SS, Bhasin DK, Rao C, Srinivasan R, Singh K. Tuberculosispresenting as dysphagia: Clinical, endoscopic, radiologicaland endosonographic features. Endoscopic ultrasound.2013;2(2):92-95
• [55] Fritscher-Ravens A, Sriram PV, Topalidis T, Hauber HP,Meyer A, Soehendra N, et al. Diagnosing sarcoidosis usingendosonography-guided fine-needle aspiration Chest. 2000Oct;118(4):928-935
• [56] Mishra G, Sahai AV, Penman ID, Williams DB, Judson MA,Lewin DN, et al. Endoscopic ultrasonography with fine-needleaspiration: an accurate and simple diagnostic modality forsarcoidosis. Endoscopy. 1999 Jun;31(5):377-382[Crossref]
• [57] Ozgul MA, Cetinkaya E, Kirkil G, et al. Lymph node characteristicsof sarcoidosis with endobronchial ultrasound.Endoscopic Ultrasound 2014;3:232-237
• [58] Puri R, Khaliq A, Kumar M, Sud R, Vasdev N. Esophagealtuberculosis: role of endoscopic ultrasound in diagnosis. DisEsophagus. 2012 Feb;25(2):102-106[Crossref]
• [59] Larsen SS, Krasnik M, Vilmann P, Jacobsen GK, Pedersen JJ,Faurschou P, et al. Endoscopic ultrasound-guided biopsy ofsuspected malignancy in the mediastinum has a major impacton the clinical decision process. Ugeskr Laeger. 2002 Jun17;164(25):3341-3346
• [60] Kramer H, van Putten JW, Douma WR, Smidt AA, van DullemenHM, Groen HJ. Technical description of endoscopic ultrasonographywith fine-needle aspiration for the staging of lungcancer. Respir Med. 2005 Feb;99(2):179-185[Crossref]
• [61] Fujii LL, Levy MJ. Basic techniques in endoscopic ultrasoundguidedfine needle aspiration for solid lesions: Adverse eventsand avoiding them. Endoscopic Ultrasound 2014;3:35-45
• [62] Okasha HH, Mansour M, Attia KA, et al. Role of high resolutionultrasound/endosonography and elastography in predictinglymph node malignancy. Endoscopic Ultrasound 2014;3:58-62
• [63] Sahai AV. Endoscopic ultrasound-guided fine-needleaspiration studies: Fanning the flames. Endoscopic Ultrasound2014;3:68-70
• [64] Sahai AV. Endoscopic ultrasound-guided fine-needleaspiration: Getting to the point. Endoscopic Ultrasound2014;3:1-2
• [65] Wani S. Basic techniques in endoscopic ultrasound-guidedfine-needle aspiration: Role of a stylet and suction. EndoscopicUltrasound 2014;3:17-21
• [66] Araujo J, Bories E, Caillol F, Pesenti C, Guiramand J, Poizat FFet al. Distant lymph node metastases in gastroesophagealjunction adenocarcinoma: Impact of endoscopic ultrasoundguidedfine-needle aspiration. Endoscopic ultrasound.2013;2(3):148-152
• [67] Costache MI, Iordache S, Karstensen JG, Saftoiu A, Vilmann P.Endoscopic ultrasound-guided fine needle aspiration: From thepast to the future. Endoscopic ultrasound. 2013;2(2):77-85
• [68] Ioncica AM, Bektas M, Suzuki R, Saftoiu A, Artifon EL, BhutaniMS. Role of EUS-FNA in recurrent lung cancer: Maximumresults with minimum (minimally invasive) effort. Endoscopicultrasound. 2013;2(2):102-104
• [69] Schuhmann M, Eberhardt R, Herth FJ. Endobronchial ultrasoundfor peripheral lesions: A review. Endoscopic ultrasound.2013;2(1):3-6
• [70] Sharma SS, Jhajharia A, Maharshi S, Ram S, Shankar V, KatiarP. Mediastinal paraganglioma: Specific endoscopic ultrasoundfeatures. Endoscopic ultrasound. 2013;2(2):105-106

Identifiers

DOI

10.1515/med-2015-0095