Pancoast tumor echocardiography or ultrasound
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overveiw
Ultrasound
Pancoast tumor, a subtype of lung cancer located at the lung apex. On endobronchial and endoscopic ultrasound, characteristic findings of lung cancer may include: enlarged lymph nodes and local invasion to adjacent bronchial structures and mediastinum. Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.[1]
Ultrasound
- Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.[1]
- Common features of endobronchial ultrasound, include: [2]
- Evaluation of lymph nodes and other structures in the mediastinum
- Mediastinum invasion staging
- Determination of management strategy
- Real time evaluation of structures
- Sensitivity 90% and specificity of 97%
- On ultrasound (endobronchial ultrasound), findings of Pancoast tumor may include: [3]
- Enlarged lymph nodes
- Local invasion to adjacent bronchial structures and mediastinum
- 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 nodes
- Useful for station 2L and 4L, L adrenal, celiac lymph node
- Cannot reliably access right sided paratracheal lymph node stations 2 R and 4R
- Accurate discrimination of primary hilar tumors and involved lymph nodes is important
Gallery
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Doppler endoscopic ultrasound: mediastinal lymph node
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Endoscopic ultrasound: A biopsy window is found and an fine needle aspiration advanced into the mass
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Endoscopic ultrasound: A lung mass which is partially behind the aorta is seen with endoscopic ultrasound
References
- ↑ 1.0 1.1 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
- ↑ Lung cancer staging. Wikipedia. https://en.wikipedia.org/wiki/Lung_cancer_staging Accessed on February 25,2016