EBUS, Granulomas, and Cancer What Does This Represent?

摘要

Lung cancer is the leading cause of cancer-related mortality worldwide. Lung cancer prognosis is strongly related to the stage of the disease, and appropriate selection of treatment is dependent on accurate staging. Regional nodal staging relies on a variety of investigations to determine the node size, metabolic activity, and cytopathologic confirmation or exclusion of malignant involvement. Determination of nodal involvement with computed tomography (on the basis of size) or positron emission tomography (on the basis of metabolic activity) is an important first step in the assessment of this patient population. However, as useful as noninvasive imaging modalities can be, they are subject to false-positive and false-negative results,1 which if relied on can lead to erroneous staging and treatment decisions. Endobron-chial ultrasound (EBUS) is now widely accepted as a lymph node staging modality in lung cancer, and has also been shown to be a useful diagnostic procedure in identifying mediastinal metastases from distant tumors.3 EBUS appears to perform as well as mediastinoscopy (the accepted gold standard for preoperative mediastinal staging) in recent comparative clinical trials.