Role of Endobronchial Ultrasound in Diagnosis of Mediastinal and Pulmonary Lesions

Abstract
Background: Lung cancer is one of the most common tumors worldwide. Now it ranks as the leading cause of cancer related death in the world, both in men and women. Pulmonary lesions detected during screening for lung cancer need to be evaluated further and tissue should be obtained. Technical development in last two decades has made it possible for pulmonologists to do endobronchial ultrasound “EBUS”.
Aim of Study: The aim of the work is Assessment of the role of endobronchial ultrasound TBNA in diagnosis of me-diastinal lesions as accurate rapid less invasive procedure.
Subjects and Methods: This is a Prospective study was conducted on 30 patients presented with chest symptoms (dyspnea, cough, expectoration, chest pain and hemoptysis) diagnosed as mediastinal, hilar and pulmonary lesions as confirmed by CT chest, routine labs and proper history taking and through clinical examination and underwent EBUS-TBNA and the sampled lesion was sent for histopathological exam-ination and reporting at Kobbry Al-Kobba Military Hospital during the period from (November 2015 to October 2016).
Results: The mean age of the patients participating in this study was 44.9±15.9 years (ranges 17–73). 56.7% of them were males while 43.3% were femles. Radiological finding showed Hilar & mediastinal lymphadenopathy in 40.0%, mediastinal lymphadenopathy (6.7%), hilar lymphadenopathy (10.0%), pulmonary lesions (33.3%), pulmonary lesions with mediastinal lymphadenopathy (6.7%), pulmonary lesions with mediastinal and hilar lymphadenopathy (3.3%). EBUS findings were 20 patients were having lymph node lesions (85% were benign and 15% were malignant by pathology) and 10 patients were having mass lesions (100% were malignant). No com-plications were detected only minor hemorrhage in 1 patients (3.3%).
Conclusion: Endobronchial ultrasound guided transbron-chial fine needle aspiration EBUS-TBNA is the procedure of choice for staging of lung cancers and for the investigation of unexplained mediastinal lymphadenopathy and masses. EBUS guided TBNA is an accurate, cost effective and mini-mally invasive procedure and if successfully performed, TBNA may spare patients additional, more invasive procedures or surgery.