Author of

• 12853

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  P3.24 - Poster Session 3 - Supportive Care (ID 160)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12859

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    P3.24-006 - The contribution of histopathological evaluation of small samples obtained by EBUS puncture for diagnosis of pathological masses in mediastinum (ID 263)

    09:30 - 09:30  |  Author(s): L. Stehlik
    • Abstract

    Background
    Endobronchial ultrasonography (EBUS) have reached an important position in diagnosis of tumors and enlarged lymph nodes involving mostly mediastinum. The puncture of pathological mediastinal masses under EBUS control is perfomed with thin needle and the obtained samples are mainly evaluated by means of cytology, which in case of malignant tumors does not give definite diagnosis including subtyping of tumor. Thus we aimed to evaluate the EBUS puncture samples also by means of histopathology including immunohistochemistry.

    Methods
    During one year we investigated 94 patients (53 males, 41 females, mean age 52 years) with enalrged lymph nodes or tumor spread involving mediastinum by EBUS puncture with sampling for cytology, histopathology and immunohistochemistry. 42 patients had suspicion of sarcoidosis, 32 lung cancer with diastinal involvement, 7 metastates of extrapulmonary tumor to mediastinal lymph nodes, 3 lymphoma and 10 pulmonary infiltrates with mediastinal lymphadenopathy probably of inflammatory origin. The investigation was performed under general anesthesy and the other samples from the invoved sites of lungs (aspirates, brushes, excisions, transbronchial biopsies (TBB), bronchoalveolar lavage (BAL)) were taken ad the same time.

    Results
    In the sarcoidosis group we obtained histopathologically evaluable samples from EBUS puncture of lymph nodes in 19 patients (45%) and in 8 of them (19%) the sarcoid granulomas were described. In lung cancer group we had valid samples in 23 patients (72%) and in 17 of them (53%) we diagnosed the carcinoma histopathologically including immunohistochemical analysis, and in 6 patients (19%) we confirmed normal lymph nodes. In the group of patients with extrapulmonary malignancy we defined histopathologically the metastases in mediastinal lymph nodes in 2 of 7 patients and in 1 sarcoidosis. In the patients with suspect lymhopma histopathological evaluation of lymph nodes did not support the diagnosis. In the group of pulmonary infiltrates with mediastinal lymhadenopathy we proved by histopathology normal or inflammatory lymph nodes in 5 of 10 patients.

    Conclusion
    Histopathological evaluation including immunohistochemical analysis of samples from EBUS puncture of tumors involving mediastinum and mediastinal lymh nodes is of important value mainly in lung cancer and metastatic cancer involvement. This approach enables the patients to avoid surgical bioptic procedures in non-resectable cases and thus helps to start the targetted tratment of lung cancer as early as possible. In case of sarcoidosis the histopathological evaluation of lymph node puncture samples rises the propability of stating definite diagnosis in combination with other prcedures (BAL, TBB).Figure 1 Fig.1 Small cell cancer, sample from EBUS puncture, EMA staining