Mediastinal “deep freeze”—transcarinal lymph node cryobiopsy
Abstract Background The diagnostic yield of endobronchial ultrasound‐transbronchial needle aspiration (EBUS‐TBNA) from mediastinal lymph nodes ranges from 66%–89%. However, in many cases cytologic material is not sufficient for full molecular evaluation. A novel method of transcarinal cryobiopsy aim...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.14422 |
| _version_ | 1817978415298379776 |
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| author | Evgeni Gershman Alon AmramIkan Barak Pertzov Dror Rosengarten Mordechai Reuven Kramer |
| author_facet | Evgeni Gershman Alon AmramIkan Barak Pertzov Dror Rosengarten Mordechai Reuven Kramer |
| author_sort | Evgeni Gershman |
| collection | DOAJ |
| description | Abstract Background The diagnostic yield of endobronchial ultrasound‐transbronchial needle aspiration (EBUS‐TBNA) from mediastinal lymph nodes ranges from 66%–89%. However, in many cases cytologic material is not sufficient for full molecular evaluation. A novel method of transcarinal cryobiopsy aims to provide bronchoscopically obtained, larger specimen samples from mediastinal lymph nodes. We aimed to assess the efficacy and safety of transcarinal EBUS‐guided lymph node cryobiopsy. Methods Patients referred for EBUS‐TBNA, based on abnormal mediastinal clinical and radiographic findings, were enrolled into this prospective interventional study between July 2020 and August 2021. All EBUS‐TBNA procedures were performed using ProCore 22G needle (Cook Medical) to create, both a transcarinal tract for the cryoprobe and to obtain TBNA samples. For EBUS guided transcarinal cryobiopsy, we used flexible 1.1 mm or 1.7 mm cryoprobe inserted into the working channel of the EBUS scope and into the target subcarinal lymph node. Results Twenty‐four patients with male predominance 2:1 and mean age of 60.12 ± 10.16 years were enrolled. All target lymph nodes had hypoechoic, homogenic consistency with demarcated borders, without central structures. Cryobiopsy provided pathological diagnosis in 20 cases (83.33%), with 1.1 mm cryoprobe in 14 and with 1.7 mm cryoprobe in 6 cases. In one case each, pathology was provided by TBNA or by cryoprobe alone. No immediate or late complications were encountered during the procedures. Conclusion Transcarinal EBUS guided lymph node cryobiopsy following EBUS‐TBNA proved to be efficient with a high diagnostic yield and can be considered safe, because no immediate or late complications occurred. |
| first_indexed | 2024-04-13T22:28:45Z |
| format | Article |
| id | doaj.art-9a345bd842f64e768bb37aaf021d3a5f |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-13T22:28:45Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-9a345bd842f64e768bb37aaf021d3a5f2022-12-22T02:26:59ZengWileyThoracic Cancer1759-77061759-77142022-06-0113111592159610.1111/1759-7714.14422Mediastinal “deep freeze”—transcarinal lymph node cryobiopsyEvgeni Gershman0Alon AmramIkan1Barak Pertzov2Dror Rosengarten3Mordechai Reuven Kramer4Pulmonary Division Rabin Medical Center Petah Tikva IsraelSackler Faculty of Medicine Tel Aviv University Tel Aviv IsraelPulmonary Division Rabin Medical Center Petah Tikva IsraelPulmonary Division Rabin Medical Center Petah Tikva IsraelPulmonary Division Rabin Medical Center Petah Tikva IsraelAbstract Background The diagnostic yield of endobronchial ultrasound‐transbronchial needle aspiration (EBUS‐TBNA) from mediastinal lymph nodes ranges from 66%–89%. However, in many cases cytologic material is not sufficient for full molecular evaluation. A novel method of transcarinal cryobiopsy aims to provide bronchoscopically obtained, larger specimen samples from mediastinal lymph nodes. We aimed to assess the efficacy and safety of transcarinal EBUS‐guided lymph node cryobiopsy. Methods Patients referred for EBUS‐TBNA, based on abnormal mediastinal clinical and radiographic findings, were enrolled into this prospective interventional study between July 2020 and August 2021. All EBUS‐TBNA procedures were performed using ProCore 22G needle (Cook Medical) to create, both a transcarinal tract for the cryoprobe and to obtain TBNA samples. For EBUS guided transcarinal cryobiopsy, we used flexible 1.1 mm or 1.7 mm cryoprobe inserted into the working channel of the EBUS scope and into the target subcarinal lymph node. Results Twenty‐four patients with male predominance 2:1 and mean age of 60.12 ± 10.16 years were enrolled. All target lymph nodes had hypoechoic, homogenic consistency with demarcated borders, without central structures. Cryobiopsy provided pathological diagnosis in 20 cases (83.33%), with 1.1 mm cryoprobe in 14 and with 1.7 mm cryoprobe in 6 cases. In one case each, pathology was provided by TBNA or by cryoprobe alone. No immediate or late complications were encountered during the procedures. Conclusion Transcarinal EBUS guided lymph node cryobiopsy following EBUS‐TBNA proved to be efficient with a high diagnostic yield and can be considered safe, because no immediate or late complications occurred.https://doi.org/10.1111/1759-7714.14422cryoprobeendobronchial ultrasoundlymph nodetranscarinal |
| spellingShingle | Evgeni Gershman Alon AmramIkan Barak Pertzov Dror Rosengarten Mordechai Reuven Kramer Mediastinal “deep freeze”—transcarinal lymph node cryobiopsy Thoracic Cancer cryoprobe endobronchial ultrasound lymph node transcarinal |
| title | Mediastinal “deep freeze”—transcarinal lymph node cryobiopsy |
| title_full | Mediastinal “deep freeze”—transcarinal lymph node cryobiopsy |
| title_fullStr | Mediastinal “deep freeze”—transcarinal lymph node cryobiopsy |
| title_full_unstemmed | Mediastinal “deep freeze”—transcarinal lymph node cryobiopsy |
| title_short | Mediastinal “deep freeze”—transcarinal lymph node cryobiopsy |
| title_sort | mediastinal deep freeze transcarinal lymph node cryobiopsy |
| topic | cryoprobe endobronchial ultrasound lymph node transcarinal |
| url | https://doi.org/10.1111/1759-7714.14422 |
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