Non small cell lung cancer ultrasound: Difference between revisions
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{{Non small cell lung cancer}} | {{Non small cell lung cancer}} | ||
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==Overview== | |||
On [[Endoscopic ultrasound|endobronchial ultrasound (EBUS)]] and [[endoscopic ultrasound]], characteristic findings of non-small cell lung cancer include [[Lymphadenopathy|enlarged lymph nodes]] and local invasion to adjacent [[bronchial]] structures and [[Mediastinal mass|mediastinum]]. [[Endoscopic ultrasound|Endobronchial ultrasound]] is a first-line diagnostic modality for [[Mediastinal mass|mediastinal staging]]. | |||
==Ultrasound== | |||
Endobronchial ultrasound is a first-line diagnostic modality for [[Mediastinal tumor|mediastinal staging]].<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref><ref name="cancer">Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016</ref> | |||
* [[Endoscopic ultrasound|Endobronchial]] and [[Endoscopic ultrasound|endoscopic esophageal ultrasound]] are mainly used to identify [[Mediastinal tumor|mediastinal metastasis]]. | |||
* On [[Endoscopic ultrasound|ultrasound (endobronchial/endoscopic esophageal ultrasound)]], characteristic findings of non-small cell lung cancer include: | |||
** [[Lymphadenopathy|Enlarged lymph nodes]] | |||
** Local invasion of adjacent [[bronchial]] structures and [[Mediastinal tumor|mediastinum]] | |||
* Indications for the [[Endoscopic ultrasound|endobronchial ultrasound]]: | |||
**Evaluation of [[Mediastinal lymph node|lymph nodes]] and other structures in the [[mediastinum]] | |||
**[[Mediastinal tumor|Mediastinal invasion staging]] | |||
**Plan for management | |||
**Real-time evaluation of structures | |||
The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer. | |||
::{| style="border:1px solid black; border-collapse:collapse" border="1" cellpadding="5" | |||
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Procedure}} | |||
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Advantages}} | |||
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Disadvantages}} | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | [[Endoscopic ultrasound|Endobronchial ultrasound (EBUS)]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Direct visualization of [[Lymph node|lymph node stations]]. | |||
*Complements endoscopic ultrasound: covers lymph node stations 2R and 4R which are difficult to access by endoscopic ultrasound | |||
*Lower false-negative rate than with blind [[Needle aspiration biopsy|transbronchial fine needle aspiration]] and fewer complications | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*More invasive than endoscopic ultrasound, few practitioners, but rapidly growing in popularity | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | [[Endoscopic ultrasound]] (EUS) | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Least invasive modality | |||
*Uses the [[esophagus]] to access [[Mediastinal lymph node|mediastinal lymph nodes]] | |||
*Excellent for staging [[lymph node metastases]] | |||
*Useful for station 2L and 4L, L adrenal, [[Celiac lymph nodes|celiac lymph node]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Cannot reliably access right sided [[Paratracheal lymph nodes|paratracheal lymph node]] stations 2R and 4R | |||
*Accurate discrimination of primary hilar tumors and involved lymph nodes is important | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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Latest revision as of 19:26, 9 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
On endobronchial ultrasound (EBUS) and endoscopic ultrasound, characteristic findings of non-small cell lung cancer include enlarged lymph nodes and local invasion to adjacent bronchial structures and mediastinum. Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.
Ultrasound
Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.[1][2]
- Endobronchial and endoscopic esophageal ultrasound are mainly used to identify mediastinal metastasis.
- On ultrasound (endobronchial/endoscopic esophageal ultrasound), characteristic findings of non-small cell lung cancer include:
- Enlarged lymph nodes
- Local invasion of adjacent bronchial structures and mediastinum
- Indications for the endobronchial ultrasound:
- Evaluation of lymph nodes and other structures in the mediastinum
- Mediastinal invasion staging
- Plan for management
- Real-time evaluation of structures
The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer.
Procedure Advantages Disadvantages Endobronchial ultrasound (EBUS) - Direct visualization of lymph node stations.
- Complements endoscopic ultrasound: covers lymph node stations 2R and 4R which are difficult to access by endoscopic ultrasound
- Lower false-negative rate than with blind transbronchial fine needle aspiration and fewer complications
- More invasive than endoscopic ultrasound, few practitioners, but rapidly growing in popularity
Endoscopic ultrasound (EUS) - Least invasive modality
- Uses the esophagus to access mediastinal lymph nodes
- Excellent for staging lymph node metastases
- Useful for station 2L and 4L, L adrenal, celiac lymph node
- Cannot reliably access right sided paratracheal lymph node stations 2R and 4R
- Accurate discrimination of primary hilar tumors and involved lymph nodes is important
References
- ↑ Kinsey CM, Arenberg DA (2014). "Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging". Am. J. Respir. Crit. Care Med. 189 (6): 640–9. doi:10.1164/rccm.201311-2007CI. PMID 24484269.
- ↑ Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016