Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies

Amira Abdelgalil Elkholy; Ali Mohamed Abdellah; Fawzy Abo-Elnaga El-emery; Ibrahim Salah-Eldein Ibrahim; Ayman Abdelhamid Farghaly; Mohamed Sayed Hantera; Ayman Mohamed El-Saka; Dalia Ezzat Elsharawy

doi:doi:10.11648/j.ijmi.20210901.19

Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies

Amira Abdelgalil Elkholy, Ali Mohamed Abdellah, Fawzy Abo-Elnaga El-emery, Ibrahim Salah-Eldein Ibrahim, Ayman Abdelhamid Farghaly, Mohamed Sayed Hantera, Ayman Mohamed El-Saka, Dalia Ezzat Elsharawy

Published in International Journal of Medical Imaging (Volume 9, Issue 1)

Received: 11 February 2021 Accepted: 26 February 2021 Published: 4 March 2021

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Abstract

Introduction: Diagnosis of mediastinal and hilar lesions represents a problematic issue for long ago, not only due to various structures that occupy this space but also difficult accessibility to such lesions. Mediastinal endosonography – guided FNA is emerged as a new minimally invasive modality for diagnosis of such lesions. Objectives: to evaluate the role of endobronchial and/ or endoesophageal -bronchoscopic ultrasound-guided fine needle aspiration in the diagnosis of mediastinal and hilar diseases of unknown etiologies. Methods: This Prospective observational study was carried out at Tanta University Educational Hospital and Kobri Elkobba Military Hospitals; from December 2017 to December 2019 on thirty patients (19 males; 11 females, age range 17-82 years) presented with undiagnosed mediastinal and or hilar lesions. All patients were subjected to clinical examination, radiological assessment including Chest-X-Ray, CT Chest. Laboratory investigations: CBC, blood urea, serum creatinine and coagulation profile. Twenty-six patients were subjected only to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsies and four patients were subjected to endoscopic ultrasound using EBUS scope-guided fine- needle aspiration (EUS-B-FNA) after EBUS-TBNA, using Pentax Endobronchial ultrasound and a fine needle (22- Gauge). The procedure was done under local anesthesia and conscious sedation ROSE technique was applied for some cases. Results: Definitive diagnosis was reached in twenty-nine cases, achieving diagnostic yield (96.67%). Malignant lesions were the predominant category; twenty (66.67%), while nine (30%) were diagnosed as benign lesions and one (3.33%) case remained un diagnosed. Also, immunohistochemistry played an important role to reach definitive diagnosis in six cases without further sampling. About (12/30; 40%) of patients were passed without any complications while the others recorded controlled complications without any serious events. Conclusion: EBUS and EUS-B-FNA are minimally invasive, complementary and cost effective procedures with high diagnostic yield for mediastinal and hilar lesions. Addition of immunohistochemistry raises diagnostic value of this procedure.

Published in	International Journal of Medical Imaging (Volume 9, Issue 1)
DOI	10.11648/j.ijmi.20210901.19
Page(s)	87-93
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Endobronchial Ultrasound, EUS-B-FNA, Mediastinal Endosonography, Mediastinal and Hilar Diseases, Immunohistochemistry

References

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APA Style

Amira Abdelgalil Elkholy, Ali Mohamed Abdellah, Fawzy Abo-Elnaga El-emery, Ibrahim Salah-Eldein Ibrahim, Ayman Abdelhamid Farghaly, et al. (2021). Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies. International Journal of Medical Imaging, 9(1), 87-93. https://doi.org/10.11648/j.ijmi.20210901.19

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ACS Style

Amira Abdelgalil Elkholy; Ali Mohamed Abdellah; Fawzy Abo-Elnaga El-emery; Ibrahim Salah-Eldein Ibrahim; Ayman Abdelhamid Farghaly, et al. Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies. Int. J. Med. Imaging 2021, 9(1), 87-93. doi: 10.11648/j.ijmi.20210901.19

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AMA Style

Amira Abdelgalil Elkholy, Ali Mohamed Abdellah, Fawzy Abo-Elnaga El-emery, Ibrahim Salah-Eldein Ibrahim, Ayman Abdelhamid Farghaly, et al. Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies. Int J Med Imaging. 2021;9(1):87-93. doi: 10.11648/j.ijmi.20210901.19

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@article{10.11648/j.ijmi.20210901.19,
  author = {Amira Abdelgalil Elkholy and Ali Mohamed Abdellah and Fawzy Abo-Elnaga El-emery and Ibrahim Salah-Eldein Ibrahim and Ayman Abdelhamid Farghaly and Mohamed Sayed Hantera and Ayman Mohamed El-Saka and Dalia Ezzat Elsharawy},
  title = {Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies},
  journal = {International Journal of Medical Imaging},
  volume = {9},
  number = {1},
  pages = {87-93},
  doi = {10.11648/j.ijmi.20210901.19},
  url = {https://doi.org/10.11648/j.ijmi.20210901.19},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20210901.19},
  abstract = {Introduction: Diagnosis of mediastinal and hilar lesions represents a problematic issue for long ago, not only due to various structures that occupy this space but also difficult accessibility to such lesions. Mediastinal endosonography – guided FNA is emerged as a new minimally invasive modality for diagnosis of such lesions. Objectives: to evaluate the role of endobronchial and/ or endoesophageal -bronchoscopic ultrasound-guided fine needle aspiration in the diagnosis of mediastinal and hilar diseases of unknown etiologies. Methods: This Prospective observational study was carried out at Tanta University Educational Hospital and Kobri Elkobba Military Hospitals; from December 2017 to December 2019 on thirty patients (19 males; 11 females, age range 17-82 years) presented with undiagnosed mediastinal and or hilar lesions. All patients were subjected to clinical examination, radiological assessment including Chest-X-Ray, CT Chest. Laboratory investigations: CBC, blood urea, serum creatinine and coagulation profile. Twenty-six patients were subjected only to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsies and four patients were subjected to endoscopic ultrasound using EBUS scope-guided fine- needle aspiration (EUS-B-FNA) after EBUS-TBNA, using Pentax Endobronchial ultrasound and a fine needle (22- Gauge). The procedure was done under local anesthesia and conscious sedation ROSE technique was applied for some cases. Results: Definitive diagnosis was reached in twenty-nine cases, achieving diagnostic yield (96.67%). Malignant lesions were the predominant category; twenty (66.67%), while nine (30%) were diagnosed as benign lesions and one (3.33%) case remained un diagnosed. Also, immunohistochemistry played an important role to reach definitive diagnosis in six cases without further sampling. About (12/30; 40%) of patients were passed without any complications while the others recorded controlled complications without any serious events. Conclusion: EBUS and EUS-B-FNA are minimally invasive, complementary and cost effective procedures with high diagnostic yield for mediastinal and hilar lesions. Addition of immunohistochemistry raises diagnostic value of this procedure.},
 year = {2021}
}

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TY  - JOUR
T1  - Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies
AU  - Amira Abdelgalil Elkholy
AU  - Ali Mohamed Abdellah
AU  - Fawzy Abo-Elnaga El-emery
AU  - Ibrahim Salah-Eldein Ibrahim
AU  - Ayman Abdelhamid Farghaly
AU  - Mohamed Sayed Hantera
AU  - Ayman Mohamed El-Saka
AU  - Dalia Ezzat Elsharawy
Y1  - 2021/03/04
PY  - 2021
N1  - https://doi.org/10.11648/j.ijmi.20210901.19
DO  - 10.11648/j.ijmi.20210901.19
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 87
EP  - 93
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20210901.19
AB  - Introduction: Diagnosis of mediastinal and hilar lesions represents a problematic issue for long ago, not only due to various structures that occupy this space but also difficult accessibility to such lesions. Mediastinal endosonography – guided FNA is emerged as a new minimally invasive modality for diagnosis of such lesions. Objectives: to evaluate the role of endobronchial and/ or endoesophageal -bronchoscopic ultrasound-guided fine needle aspiration in the diagnosis of mediastinal and hilar diseases of unknown etiologies. Methods: This Prospective observational study was carried out at Tanta University Educational Hospital and Kobri Elkobba Military Hospitals; from December 2017 to December 2019 on thirty patients (19 males; 11 females, age range 17-82 years) presented with undiagnosed mediastinal and or hilar lesions. All patients were subjected to clinical examination, radiological assessment including Chest-X-Ray, CT Chest. Laboratory investigations: CBC, blood urea, serum creatinine and coagulation profile. Twenty-six patients were subjected only to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsies and four patients were subjected to endoscopic ultrasound using EBUS scope-guided fine- needle aspiration (EUS-B-FNA) after EBUS-TBNA, using Pentax Endobronchial ultrasound and a fine needle (22- Gauge). The procedure was done under local anesthesia and conscious sedation ROSE technique was applied for some cases. Results: Definitive diagnosis was reached in twenty-nine cases, achieving diagnostic yield (96.67%). Malignant lesions were the predominant category; twenty (66.67%), while nine (30%) were diagnosed as benign lesions and one (3.33%) case remained un diagnosed. Also, immunohistochemistry played an important role to reach definitive diagnosis in six cases without further sampling. About (12/30; 40%) of patients were passed without any complications while the others recorded controlled complications without any serious events. Conclusion: EBUS and EUS-B-FNA are minimally invasive, complementary and cost effective procedures with high diagnostic yield for mediastinal and hilar lesions. Addition of immunohistochemistry raises diagnostic value of this procedure.
VL  - 9
IS  - 1
ER  -

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Author Information

Amira Abdelgalil Elkholy

Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Ali Mohamed Abdellah

Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Fawzy Abo-Elnaga El-emery

Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Ibrahim Salah-Eldein Ibrahim

Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Ayman Abdelhamid Farghaly

Chest Diseases Department, Kobri Elkobba Military Hospital, Medical Military Academy, Cairo, Egypt
Mohamed Sayed Hantera

Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Ayman Mohamed El-Saka

Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Dalia Ezzat Elsharawy

Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt

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APA Style

Amira Abdelgalil Elkholy, Ali Mohamed Abdellah, Fawzy Abo-Elnaga El-emery, Ibrahim Salah-Eldein Ibrahim, Ayman Abdelhamid Farghaly, et al. (2021). Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies. International Journal of Medical Imaging, 9(1), 87-93. https://doi.org/10.11648/j.ijmi.20210901.19

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ACS Style

Amira Abdelgalil Elkholy; Ali Mohamed Abdellah; Fawzy Abo-Elnaga El-emery; Ibrahim Salah-Eldein Ibrahim; Ayman Abdelhamid Farghaly, et al. Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies. Int. J. Med. Imaging 2021, 9(1), 87-93. doi: 10.11648/j.ijmi.20210901.19

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AMA Style

Amira Abdelgalil Elkholy, Ali Mohamed Abdellah, Fawzy Abo-Elnaga El-emery, Ibrahim Salah-Eldein Ibrahim, Ayman Abdelhamid Farghaly, et al. Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies. Int J Med Imaging. 2021;9(1):87-93. doi: 10.11648/j.ijmi.20210901.19

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@article{10.11648/j.ijmi.20210901.19,
  author = {Amira Abdelgalil Elkholy and Ali Mohamed Abdellah and Fawzy Abo-Elnaga El-emery and Ibrahim Salah-Eldein Ibrahim and Ayman Abdelhamid Farghaly and Mohamed Sayed Hantera and Ayman Mohamed El-Saka and Dalia Ezzat Elsharawy},
  title = {Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies},
  journal = {International Journal of Medical Imaging},
  volume = {9},
  number = {1},
  pages = {87-93},
  doi = {10.11648/j.ijmi.20210901.19},
  url = {https://doi.org/10.11648/j.ijmi.20210901.19},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20210901.19},
  abstract = {Introduction: Diagnosis of mediastinal and hilar lesions represents a problematic issue for long ago, not only due to various structures that occupy this space but also difficult accessibility to such lesions. Mediastinal endosonography – guided FNA is emerged as a new minimally invasive modality for diagnosis of such lesions. Objectives: to evaluate the role of endobronchial and/ or endoesophageal -bronchoscopic ultrasound-guided fine needle aspiration in the diagnosis of mediastinal and hilar diseases of unknown etiologies. Methods: This Prospective observational study was carried out at Tanta University Educational Hospital and Kobri Elkobba Military Hospitals; from December 2017 to December 2019 on thirty patients (19 males; 11 females, age range 17-82 years) presented with undiagnosed mediastinal and or hilar lesions. All patients were subjected to clinical examination, radiological assessment including Chest-X-Ray, CT Chest. Laboratory investigations: CBC, blood urea, serum creatinine and coagulation profile. Twenty-six patients were subjected only to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsies and four patients were subjected to endoscopic ultrasound using EBUS scope-guided fine- needle aspiration (EUS-B-FNA) after EBUS-TBNA, using Pentax Endobronchial ultrasound and a fine needle (22- Gauge). The procedure was done under local anesthesia and conscious sedation ROSE technique was applied for some cases. Results: Definitive diagnosis was reached in twenty-nine cases, achieving diagnostic yield (96.67%). Malignant lesions were the predominant category; twenty (66.67%), while nine (30%) were diagnosed as benign lesions and one (3.33%) case remained un diagnosed. Also, immunohistochemistry played an important role to reach definitive diagnosis in six cases without further sampling. About (12/30; 40%) of patients were passed without any complications while the others recorded controlled complications without any serious events. Conclusion: EBUS and EUS-B-FNA are minimally invasive, complementary and cost effective procedures with high diagnostic yield for mediastinal and hilar lesions. Addition of immunohistochemistry raises diagnostic value of this procedure.},
 year = {2021}
}

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TY  - JOUR
T1  - Endobronchial and/or Endoesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Mediastinal and Hilar Diseases of Unknown Etiologies
AU  - Amira Abdelgalil Elkholy
AU  - Ali Mohamed Abdellah
AU  - Fawzy Abo-Elnaga El-emery
AU  - Ibrahim Salah-Eldein Ibrahim
AU  - Ayman Abdelhamid Farghaly
AU  - Mohamed Sayed Hantera
AU  - Ayman Mohamed El-Saka
AU  - Dalia Ezzat Elsharawy
Y1  - 2021/03/04
PY  - 2021
N1  - https://doi.org/10.11648/j.ijmi.20210901.19
DO  - 10.11648/j.ijmi.20210901.19
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 87
EP  - 93
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20210901.19
AB  - Introduction: Diagnosis of mediastinal and hilar lesions represents a problematic issue for long ago, not only due to various structures that occupy this space but also difficult accessibility to such lesions. Mediastinal endosonography – guided FNA is emerged as a new minimally invasive modality for diagnosis of such lesions. Objectives: to evaluate the role of endobronchial and/ or endoesophageal -bronchoscopic ultrasound-guided fine needle aspiration in the diagnosis of mediastinal and hilar diseases of unknown etiologies. Methods: This Prospective observational study was carried out at Tanta University Educational Hospital and Kobri Elkobba Military Hospitals; from December 2017 to December 2019 on thirty patients (19 males; 11 females, age range 17-82 years) presented with undiagnosed mediastinal and or hilar lesions. All patients were subjected to clinical examination, radiological assessment including Chest-X-Ray, CT Chest. Laboratory investigations: CBC, blood urea, serum creatinine and coagulation profile. Twenty-six patients were subjected only to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsies and four patients were subjected to endoscopic ultrasound using EBUS scope-guided fine- needle aspiration (EUS-B-FNA) after EBUS-TBNA, using Pentax Endobronchial ultrasound and a fine needle (22- Gauge). The procedure was done under local anesthesia and conscious sedation ROSE technique was applied for some cases. Results: Definitive diagnosis was reached in twenty-nine cases, achieving diagnostic yield (96.67%). Malignant lesions were the predominant category; twenty (66.67%), while nine (30%) were diagnosed as benign lesions and one (3.33%) case remained un diagnosed. Also, immunohistochemistry played an important role to reach definitive diagnosis in six cases without further sampling. About (12/30; 40%) of patients were passed without any complications while the others recorded controlled complications without any serious events. Conclusion: EBUS and EUS-B-FNA are minimally invasive, complementary and cost effective procedures with high diagnostic yield for mediastinal and hilar lesions. Addition of immunohistochemistry raises diagnostic value of this procedure.
VL  - 9
IS  - 1
ER  -

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