Diagnostic value of endobronchial ultrasound guided tran小ronchial needle aspiration in superior vena cava syndrome

• Published in: 中华医学杂志：英文版 2013 (23), p.4453-4456
• Main Author: ZHOU Zu-li ZHAO Hui LI Yun SUI Xi-zhao XIE Zhen CHEN Ke-zhong YANG Feng LI Feng-wei LIU Jun ZHENG Hong-fang WANG Jun
• Format: Article
• Language: English
• Subjects: 引导; 支气管; 综合征; 血管内支架; 诊断价值; 超声检查; 静脉; 鳞状细胞癌
• ISSN: 0366-6999; 2542-5641

Background The pathological diagnosis is of critical importance to the subsequent treatment for the pathients with superior vena cava syndrome （SVCS）.The aim of this study is to report our experience in the diagnosis of SVCS by endobronchial ultrasound guided transbronchial needle aspiration （EBUS-TBNA）.Methods The data of 520 patients who underwent EBUS-TBNA from September 2009 to May 2012 at our institution were reviewed.Of these,there were 14 males and 6 females （mean age of 59.1 years） with SVCS who received EBUS-TBNA that were included in the analysis.Results The mean short axis diameter of the paratracheal lesions was （3.32±1.79） cm （range,1.69 to 9.50 cm） and 6 cases also had subcarinal lymph node enlargement with a mean short axis diameter of （2.14±0.49） cm （range,1.73 to 3.01 cm）.An average of 4.3 punctures was performed per lesion.Malignancy was confirmed in 16 cases （10 small cell carcinomas,4 adenocarcinomas,1 squamous cell carcinoma and 1 Hodgkin lymphoma）.In two patients,pathological examination of tissue revealed no evidence of malignancy and for 13 to 24 months of follow-up.One patient from whom adequate tissue was not obtained refused further surgical biopsy since he had undergone endovascular stenting of the SVC.One patient in whom a diagnosis was not obtained by EBUS-TBNA underwent thoracoscopic biopsy and the final diagnosis was B cell non-Hodgkin＇s lymphoma.The diagnosis accuracy of EBUS-TBNA in SVCS was 18/20 patients.Conclusion EBUS-TBNA is a highly effective and safe procedure for the diagnosis of SVCS.