Recent advances in endobronchial ultrasound-guided transbronchial needle aspiration
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Nakajima, Takahiro
[1
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Yasufuku, Kazuhiro
[2
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Fujiwara, Taiki
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Chiba Univ, Grad Sch Med, Dept Gen Thorac Surg, Chuo Ku, I-8-1 Inohana, Chiba 2608670, JapanChiba Univ, Grad Sch Med, Dept Gen Thorac Surg, Chuo Ku, I-8-1 Inohana, Chiba 2608670, Japan
Fujiwara, Taiki
[1
]
Yoshino, Ichiro
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Chiba Univ, Grad Sch Med, Dept Gen Thorac Surg, Chuo Ku, I-8-1 Inohana, Chiba 2608670, JapanChiba Univ, Grad Sch Med, Dept Gen Thorac Surg, Chuo Ku, I-8-1 Inohana, Chiba 2608670, Japan
Yoshino, Ichiro
[1
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[1] Chiba Univ, Grad Sch Med, Dept Gen Thorac Surg, Chuo Ku, I-8-1 Inohana, Chiba 2608670, Japan
[2] Univ Toronto, Univ Hlth Network, Toronto Gen Hosp, Div Thorac Surg, Toronto, ON, Canada
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality for sampling of mediastinal and hilar lymph nodes as well as pulmonary lesions adjacent to the airway. Guidelines for staging of lung cancer suggest that EBUS-TBNA should be considered the best first test of nodal staging for radiologically abnormal lymph nodes that are accessible by this approach. The application of EBUS-TBNA in pulmonary medicine and thoracic oncology is expanding with its role in the diagnosis of sarcoidosis, lymphoma, and tuberculosis. Especially for patients with early-stage sarcoidosis with adenopathy and minimal changes in the lung parenchyma, EBUS-TBNA has a significantly higher diagnostic yield compared to the conventional bronchoscopic modalities. Multidirectional analysis of samples obtained by EBUS-TBNA has allowed assessment of lymphoma and molecular analysis in lung cancer. Histological evaluation with immunohistochemistry, flow cytometry, fluorescence in situ hybridization, and chromosome analysis can be performed if good quality samples can be obtained. Molecular analyses such as identification of epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) fusion gene detection now are being performed routinely with good sampling. One of the advantages of EBUS-TBNA is the ability to perform repeat procedures in a minimally invasive way. Restaging of the mediastinum after induction therapy can be done safely and with ease compared to repeat surgical procedures. With improvement in molecular analysis technology, comprehensive gene expression analysis will become important in the management of patients with lung cancer. Further advances in EBUS technology and needles for tissue sampling likely will help bronchoscopists to acquire ideal tissue. (C) 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.
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Kantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, SwitzerlandKantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, Switzerland
Dusemund, Frank
Schneider, Tino
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Kantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, SwitzerlandKantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, Switzerland
Schneider, Tino
Zeisel, Christoph
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Kantonsspital St Gallen, Dept Surg, CH-9007 St Gallen, SwitzerlandKantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, Switzerland
Zeisel, Christoph
Rothermundt, Christian
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Kantonsspital St Gallen, Dept Internal Med, Div Hematol & Oncol, CH-9007 St Gallen, SwitzerlandKantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, Switzerland
Rothermundt, Christian
Kluckert, Thomas
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Kantonsspital St Gallen, Inst Radiol, CH-9007 St Gallen, SwitzerlandKantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, Switzerland
Kluckert, Thomas
Schmid, Sabine
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Kantonsspital St Gallen, Dept Internal Med, Div Hematol & Oncol, CH-9007 St Gallen, SwitzerlandKantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, Switzerland
Schmid, Sabine
Brutsche, Martin H.
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Kantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, SwitzerlandKantonsspital St Gallen, Dept Internal Med, Div Pneumol, CH-9007 St Gallen, Switzerland
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Oki, M.
Saka, H.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Saka, H.
Kitagawa, C.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Kitagawa, C.
Kogure, Y.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Kogure, Y.
Ryuge, M.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Ryuge, M.
Tsuboi, R.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Tsuboi, R.
Oka, S.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Oka, S.
Nakahata, M.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Nagoya Med Ctr, Dept Infect Dis, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Nakahata, M.
Funahashi, Y.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Funahashi, Y.
Hori, K.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Hori, K.
Murakami, Y.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan
Murakami, Y.
Ise, Y.
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Nagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, JapanNagoya Med Ctr, Dept Resp Med, Nagoya, Aichi, Japan