The diagnostic efficacy of combining bronchoscopic tissue biopsy and endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of malignant lesions in the lung

Lauren Ende Schwartz*, Dara L. Aisner, Zubair W. Baloch, Daniel Sterman, Anil Vachani, Colin Thomas Gillespie, Andrew Haas, Leslie A. Litzky

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Bronchoscopic tissue forceps biopsy (BBX) is a standard procedure for diagnosis of malignancy in the lung. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has proven to be a sensitive alternative to tissue biopsy for the diagnosis and staging of lung tumors. We report our institutional experience with diagnostic yield when combining BBX and EBUS-TBNA in the bronchoscopic evaluation of patients presenting with lung lesion(s). The pathology files at our institution were searched for all patients who underwent combined BBX and EBUS-TBNA procedures between 1/09 and 6/10 for the diagnosis of malignancy. The data points included biopsy site, cytologic, and histopathologic diagnoses and follow-up. We identified 115 patients who underwent BBX combined with EBUS-TBNA. About 107 (93%) of the patients received a definitive pathologic diagnosis; 93 (81%) were malignant. BBX and EBUS-TBNA of the lung lesion only were performed in 21 patients, BBX and EBUS-TBNA of lymph node(s) only in 78 patients with BBX and a combination of EBUS-TBNA of the lung lesion and lymph node(s) in 16 patients. Immunostains were performed for 71 (76%) patients and molecular testing for 11 (12%) patients. Diagnostic yield is increased when bronchoscopic technologies are combined. In a significant number of patients where BBX was negative, EBUS-TBNA provided diagnostic material, increasing diagnostic yield by 18%. In a subset of these patients the EBUS-TBNA assisted in the staging of a primary tumor. By combining these procedures, more tissue was obtained for immunohistochemistry and molecular testing, which facilitated personalized management in a minimally invasive manner.

Original languageEnglish (US)
Pages (from-to)929-935
Number of pages7
JournalDiagnostic Cytopathology
Volume41
Issue number11
DOIs
StatePublished - Nov 1 2013

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Needles
Biopsy
Lung
Lymph Nodes
Neoplasms
Neoplasm Staging
Surgical Instruments
Immunohistochemistry
Pathology
Technology

Keywords

  • bronchoscopy
  • EBUS-TBNA
  • endobronchial
  • lung
  • transbronchial

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Schwartz, Lauren Ende ; Aisner, Dara L. ; Baloch, Zubair W. ; Sterman, Daniel ; Vachani, Anil ; Gillespie, Colin Thomas ; Haas, Andrew ; Litzky, Leslie A. / The diagnostic efficacy of combining bronchoscopic tissue biopsy and endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of malignant lesions in the lung. In: Diagnostic Cytopathology. 2013 ; Vol. 41, No. 11. pp. 929-935.
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abstract = "Bronchoscopic tissue forceps biopsy (BBX) is a standard procedure for diagnosis of malignancy in the lung. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has proven to be a sensitive alternative to tissue biopsy for the diagnosis and staging of lung tumors. We report our institutional experience with diagnostic yield when combining BBX and EBUS-TBNA in the bronchoscopic evaluation of patients presenting with lung lesion(s). The pathology files at our institution were searched for all patients who underwent combined BBX and EBUS-TBNA procedures between 1/09 and 6/10 for the diagnosis of malignancy. The data points included biopsy site, cytologic, and histopathologic diagnoses and follow-up. We identified 115 patients who underwent BBX combined with EBUS-TBNA. About 107 (93{\%}) of the patients received a definitive pathologic diagnosis; 93 (81{\%}) were malignant. BBX and EBUS-TBNA of the lung lesion only were performed in 21 patients, BBX and EBUS-TBNA of lymph node(s) only in 78 patients with BBX and a combination of EBUS-TBNA of the lung lesion and lymph node(s) in 16 patients. Immunostains were performed for 71 (76{\%}) patients and molecular testing for 11 (12{\%}) patients. Diagnostic yield is increased when bronchoscopic technologies are combined. In a significant number of patients where BBX was negative, EBUS-TBNA provided diagnostic material, increasing diagnostic yield by 18{\%}. In a subset of these patients the EBUS-TBNA assisted in the staging of a primary tumor. By combining these procedures, more tissue was obtained for immunohistochemistry and molecular testing, which facilitated personalized management in a minimally invasive manner.",
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The diagnostic efficacy of combining bronchoscopic tissue biopsy and endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of malignant lesions in the lung. / Schwartz, Lauren Ende; Aisner, Dara L.; Baloch, Zubair W.; Sterman, Daniel; Vachani, Anil; Gillespie, Colin Thomas; Haas, Andrew; Litzky, Leslie A.

In: Diagnostic Cytopathology, Vol. 41, No. 11, 01.11.2013, p. 929-935.

Research output: Contribution to journalArticle

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