Endoscopic ultrasound and/or endobronchial ultrasound-guided needle biopsy of central intraparenchymal lung lesions not adjacent to airways or esophagus

It is usually challenging to diagnose intraparenchymal pulmonary nodules and masses that are not adjacent to central airways or esophagus. We evaluated the diagnostic accuracy and safety of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) and/or endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) for these lesions. We performed an Internal Review Board-approved retrospective analysis of all patients who underwent EBUS, EUS, or both for the diagnosis of centrally located pulmonary nodules and masses between November 2008 and July 2013. We report results as median values with ranges. We identified 16 consecutive patients who underwent EBUS-TBNA and/or EUS-FNA of pulmonary nodules and masses not adjacent to airways or esophagus. We performed EBUS-FNA in 10 patients, EUS-FNA in five patients, and both EBUS-FNA and EUS-FNA in one patient. Median lung lesion size was 22.5 mm (11-45 mm) and median distance from airway or esophagus was 19 mm (5-30 mm). We obtained a tissue diagnosis in 15 patients (93.8%). There were no procedure-related complications. We conclude that EBUS-TBNA and/or EUS-FNA are accurate and safe for the diagnosis of intraparenchymal pulmonary lesions that are not adjacent to central airways or esophagus.