Endobronchial ultrasound-guided transbronchial biopsy using novel thin bronchoscope for diagnosis of peripheral pulmonary lesions

J Thorac Oncol. 2009 Oct;4(10):1274-7. doi: 10.1097/JTO.0b013e3181b623e1.


Background: The aim of this study was to evaluate the diagnostic utility of endobronchial ultrasound (EBUS)-guided transbronchial biopsy (TBB) using a novel 3.4-mm thin bronchoscope and a 1.4-mm ultrasonic probe for peripheral pulmonary lesions.

Methods: A total of 86 patients with suspected peripheral lesions were included in this prospective study. EBUS-TBBs were performed using a prototype 3.4-mm thin bronchoscope and a 1.4-mm radial ultrasonic probe under fluoroscopic guidance.

Results: Twelve patients with endobronchial lesions within the segmental bronchi and three patients who did not return to follow-up were excluded from this analysis. Thus, a total of 71 patients with peripheral pulmonary lesions (mean size, 31.2 +/- 12.7 mm) were included in the final analysis. The mean bronchus level reached with the thin bronchoscope was 4.6 generations. Diagnostic histologic specimens were obtained in 49 of 71 patients (69%:80% for malignant lesions and 52% for benign lesions). A definitive diagnosis of malignancy for lesions > or =20 mm and lesions < 20 mm was made in 82% (31 of 38) and 67% (four of six), respectively. There were no significant complications.

Conclusion: The EBUS-TBB using a 3.4-mm thin bronchoscope and a 1.4-mm radial probe is feasible, accurate, and safe for the diagnosis of peripheral pulmonary lesions.

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / secondary
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Bronchoscopy*
  • Carcinoma, Large Cell / diagnostic imaging
  • Carcinoma, Large Cell / pathology
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / secondary
  • Endosonography / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Prospective Studies
  • Sensitivity and Specificity
  • Small Cell Lung Carcinoma / diagnostic imaging
  • Small Cell Lung Carcinoma / pathology
  • Solitary Pulmonary Nodule / diagnostic imaging*
  • Solitary Pulmonary Nodule / pathology
  • Survival Rate