EUS-B-FNA for Diagnosing Liver and Celiac Metastases in Lung Cancer Patients

Respiration. 2019;98(5):428-433. doi: 10.1159/000501834. Epub 2019 Sep 27.

Abstract

Background: In patients with suspected or proven lung cancer, assessment of regional nodal and distant metastases is key before treatment planning. By introducing the endobronchial ultrasound (EBUS)-guided scope into the esophagus and stomach (EUS-B), liver lesions and celiac nodes can be visualized. To date, the utility of EUS-B in diagnosing liver lesions and retroperitoneal lymph nodes is unknown.

Objectives: To assess the feasibility, safety, and diagnostic yield of sampling of liver lesions and retroperitoneal nodes by EUS-B fine-needle aspiration (FNA) in a lung cancer staging setting.

Method: Consecutive patients suspected of lung cancer in 2 Danish centers between 1 January 2015 and 31 December 2017 were included retrospectively when a lesion in the liver or a retroperitoneal lymph node was visualized and biopsied with EUS-B-FNA.

Results: 23 left liver lobe lesions and 19 retroperitoneal lymph nodes were sampled by EUS-B-FNA. Sensitivity and diagnostic yield of sampled liver lesions were 86 and 83%, respectively. In 19/23 patients, there was a cytopathological diagnosis of malignancy. Sensitivity and diagnostic yield from retroperitoneal lymph node samples were 83 and 63%, respectively. In 10/19 patients, the diagnosis was malignancy. No complications were observed.

Conclusion: EUS-B-FNA enables safe sampling of left liver lobe lesions and retroperitoneal lymph nodes. EUS-B should be considered as a minimally invasive technique to provide tissue proof of distant metastases lung cancer patients.

Keywords: EBUS; EUS; EUS-B; Liver; Lung cancer; Metastases; Retroperitoneum.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchoscopy / methods*
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods*
  • Female
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / secondary
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Retroperitoneal Neoplasms / diagnosis*
  • Retrospective Studies