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Canadian Respiratory Journal
Volume 2016, Article ID 1652178, 4 pages
Research Article

Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging

1Interventional Pulmonology, Division of Pulmonary Medicine and Critical Care, University of Miami Miller School of Medicine, Miami, FL, USA
2Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 9677 Jingshi East Road, Jinan 250041, China
3Interventional Pulmonology, Division of Pulmonary Medicine and Critical Care, Johns Hopkins University, School of Medicine, 1800 Orleans Street, Suite 7125L, Baltimore, MD 21287, USA

Received 6 July 2016; Revised 8 November 2016; Accepted 16 November 2016

Academic Editor: Rocco Trisolini

Copyright © 2016 S. Arias et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Lung cancer is the leading cause of malignancy related mortality in the United States. Accurate staging of NSCLC influences therapeutic decisions. Transbronchial needle aspiration (TBNA) and endobronchial ultrasound-guided TBNA (EBUS-TBNA) has been accepted as a procedure for the diagnosis and staging of lung cancer. The aim of this study is to evaluate the efficacy and adequacy of TBNA and EBUS-TBNA for sampling of mediastinal adenopathy using the Wang’s eleven lymph node map stations. Methods. We retrospectively reviewed 99 consecutive cases diagnosed with malignancy by EBUS-TBNA and a series 74 patients evaluated for mediastinal adenopathy or a pulmonary lesion using conventional transbronchial needle aspiration. The IASLC lymph node map was correlated with Wang’s map. Results. A total of 182 lymph node stations were sampled using EBUS-TBNA. 96 were positive for nodal metastasis. A total of four cases of samples taken from station 2R showed malignant cells. From the 74 cases series using cTBNA 167 nodes were sampled in 222 passes. Lymphoid or malignant tissue was obtained in 67 (91.8%) cases; 55.1% of the nodes were 1 cm or less. Conclusions. The use of the eleven stations described in Wang’s map to guide TBNA of the mediastinal nodes allows sampling of radiologically considered nonpathological nodes. These data suggest that Wang’s map covers the most frequent IASLC nodal stations compromised with metastasis.