ENDOBRONŞİYAL ULTRASONOGRAFİ EŞLİĞİNDE YAPILAN TRANSBRONŞİAL İĞNE ASPİRASYONUNUN KÜÇÜK HÜCRELİ AKCİĞER KANSERİ TANISINDAKİ ROLÜ

Öz

Giriş: Endobronşiyal ultrasonografinin (EBUS) küçük hücreli akciğer kanserinin (KHAK) tanısındaki rolünü değerlendirmek. Gereç ve Yöntem: Aralık 2008 - Ekim 2014 tarihleri arasında EBUS yapılan olguların dosyaları retrospektif olarak incelendi. Final tanısı KHAK olan olguların demografik özellikleri, radyolojik görünümleri, EBUS ile örneklenen lenf bezlerinin kısa aksları kayıt edildi. Bulgular: Final tanısı EBUS ile konulan, yaş ortalaması 60,2±8,7 yıl olan 12(%21.1)si kadın, 45(%78.9)i erkek 57 hastada KHAK tanısı mevcuttu ve bu olgular çalışma kapsamına alındı. EBUS öncesi fiberoptik bronkoskopi yapılan 25 olgunun 24 (%96)ünde endobronşiyal lezyon saptanmamış, 1 olguda ise endobronşiyal kitleden alınan biyopsi tanısal olmamıştı. Yedi olguda transtorasik iğne aspirasyon biyopsisi yapılmıştı ve bunların hiçbiri tanısal değildi. 57 olguda 67 hiler ve mediastinal LAM, 19 peribronşiyal kitleden EBUS TBNA yapıldı. Ortalama lenf bezi kısa aksı 2,38±1,08 cm idi. EBUS-TBNA yapılan 67 LN dan 54(%80.6)ünde küçük hücreli akciğer kanseri tanısı elde edildi. 19 olguda ise peribronşiyal kitleden TBNA yapıldı ve bu olguların hepsinde (%100) kitleden yapılan TBNA tanısal idi. Bu olgularda primer kitlenin ortalama boyutu 4,04 (2- 7) cm idi. Olgu bazında ele alındığında EBUS ile 57 olgunun 55ine KHAK tanısı konuldu (sensitivite %96,5). EBUS ile tanı konulamayan 2 olguda mediastinoskopi ile KHAK tanısı elde edildi. Sonuç: Konvansiyonel yöntemlerle tanı konulamayan KHAK olgularında EBUS yüksek sensitivitesi nedeniyle alternatif bir tanı yöntemi olarak düşünülmelidir.

Anahtar Kelimeler

• Küçük hücreli akciğer kanseri, endobronşial ultrasonografi, tanı

THE UTILITY OF ENDOBRONCHIAL ULTRASOUND GUIDED TRANSBRONCHIAL NEEDLE ASPIRATION IN THE DIAGNOSIS OF SMALL CELL LUNG CANCER

Abstract

Aim: To assess the utility of endobronchial ultrasound (EBUS) guided transbronchial needle aspiration in the diagnosis of small cell lung cancer (SCLC). Material and Methods: The files of subjects who had undergone EBUS between December 2008- October 2014 were retrospectively evaluated. The demographic data, radiological findings and the short diameter measurements of the sampled lymph nodes of subjects finally diagnosed as SCLC were recorded. Results: Fifty-seven subjects were diagnosed as SCLC with EBUS. The mean age of 12 (21.1%) female and 45 (78.9%) male subjects was 60,2±8,7. Fiberoptic bronchoscopy was applied to 25 subjects prior to EBUS; 24 had no endobronchial lesion and biopsy was nondiagnostic in one case with endobronchial lesion. Seven cases had transthoracic needle aspiration biopsy, but none was diagnostic. We sampled 67 lymph nodes and 19 peribronchial mass lesions by EBUS-TBNA. The mean lymph node short diameter length was 2.38±1.08 cm. Of 67 lymph nodes, 54 (80.6%) demonstrated SCLC. Of 19 peribronchial mass lesions, all (100%) were diagnostic for SCLC. Mean length of primary mass lesions was 4.04 (2- 7) cm. Overall, 55 of 57 subjects were diagnosed as SCLC with EBUS (sensitivity 96.5%). Two cases with nondiagnostic samples underwent mediastinoscopy and got diagnosis of SCLC. Discussion: EBUS is an alternative diagnostic tool with high sensitivity for SCLC when conventional methods remain nondiagnostic.

Keywords

• Small cell lung cancer, endobronchial ultrasound, diagnosis

Kaynakça

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