Author of

• 12759

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  P3.17 - Poster Session 3 - Bronchoscopy, Endoscopy (ID 185)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track:
  • Presentations: 2
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12760

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    P3.17-001 - Assessment of pulmonary hemorrhage by bronchoscopy and CT findings in patients treated with bevacizumab (ID 1215)

    09:30 - 09:30  |  Author(s): H. Handa
    • Abstract

    Background
    Pulmonary hemorrhage (PH) is a serious adverse event for patients treated with bevacizumab (BV). Previous studies have identified PH risk factors as tumor cavitation, location, and endobronchial invasion confirmed by computed tomography (CT). However, for endobronchial invasion, we believe confirmation should be judged by bronchoscopy. The aim of this study is to demonstrate the relevance of bronchoscopic findings for patients with PH and treated with BV.

    Methods
    Retrospective analysis of non-small cell lung cancer was performed on patients treated with combination therapy including BV, as a first line chemotherapy at St. Marianna University Hospital between April 2010 and June 2013. Clinical data were retrieved from medical records and criteria from previous studies were used to identify tumor locations. Bronchoscopic findings were classified as follows; epithelial, subepithelial, extraluminal, and normal.

    Results
    Of the twenty-nine patients analyzed in this study, 24 patents underwent bronchoscopy before BV treatment. The median age was 62 years (range 38-78), and adenocarcinoma was confirmed in all patients histologically. PH was present in 10.3% patients (3/29, all Grade1), and the location of tumors (central vs. peripheral), was not a significant risk factor for PH (p=0.63). Bronchoscopic classification of patients for epithelial, subepithelial, extraluminal, normal were; 0, 18, 0, 6, respectively. Dilatation findings of subepithelial vessels were seen in 2 cases (2/24). There was no significant difference for PH in bronchoscopic classifications (subepithelial vs. normal, p=0.38); however, patients with dilatation findings of subepithelial vessels were at significantly higher risk for PH (p=0.01).

    Conclusion
    It might be possible that patients were safely treated with BV in spite of central lesions confirmed by CT. However, dilatation finding of subepithelial vessels should be observed carefully under bronchoscopy, since these findings may predict PH risk factors for BV.

  • 12765

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    P3.17-006 - Endobronchial Ultrasound Elastography in mediastinal lymph nodes: initial experiences (ID 2227)

    09:30 - 09:30  |  Author(s): H. Handa
    • Abstract

    Background
    To determine the feasibility Endobronchial Ultrasound (EBUS) Elastography for mediastinal lymph nodes (LNs)

    Methods
    Mediastinal LNs in sarcoidosis (n=5) and metastatic LNs in lung cancer patients (n=7) were examined with B-mode ultrasound, Doppler and EBUS elastography. The elasticity distributions were classified into homogenous green pattern, Heterogenous blue-predominant pattern, ad Homogenous blue pattern. The strain ratio (strain of LN/ strain of fatty tissue) was measured in 3 cases of sarcoidosis and 2 cases of metastatic LNs.

    Results
    In the elastogram, green on the EBUS images correspond to relatively soft tissue and blue correspond to relatively hard tissue. In the elastogram, mediastinal LNs in sarcoidosis of all 5 cases were classified in homogenous green pattern. In the elastogram of metastatic LNs in 7 lung cancer patients, LNs of 5 cases were classified in heterogenous blue-predominant pattern and LNs of the residual 2 cases were classified in homogenous blue pattern. Homogenous green pattern A blue-predominant pattern, either homogenous or heterogenous, supported the diagnosis of malignant LNs. The strain ratio was 1.31, 3.16, and 5.48 in 3 cases of sarcoidosis respectively, and 17.65 and 29.0 in 2 cases of metastatic LNs respectively.

    Conclusion
    EBUS elastography would be a feasible method to visualize the elasticity of mediastinal LNs.