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Role of EUS in Mediastinal Nodes, Masses, Cysts, and Lung Cancer

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Endoscopic Ultrasound

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Full minimally invasive evaluation of all lymph node stations (with the exception of station 6) is now possible with the advent of endobronchial and trans-esophageal endoscopic ultrasound. Endoscopic ultrasound fine-needle aspiration (EUS-FNA) allows sampling of mediastinal lymph nodes relevant to lung cancer staging, particularly in the subcarinal area (station 7), lower para-esophageal lymph nodes (station 8), inferior pulmonary ligament lymph nodes (station 9), and celiac lymph nodes. EUS-FNA is an extremely powerful nonsurgical option for sampling metastatic nodes, sarcoidosis, and lymphoma. Both adrenal glands can be sampled by EUS-FNA through the trans-gastric approach or the trans-duodenal approach. EUS-FNA is also able to sample central primary lung masses abutting the esophagus, particularly when other techniques fail. EBUS-FNA has the distinct advantage to reach areas that have proven inaccessible to EUS. These stations include the right and left upper and lower para-tracheal areas (4R and 4L; 2R and 2L), right and left hilar areas (station 10) and the right and left interlobar stations (station 11). It is best to work in a multidisciplinary fashion with colleagues in thoracic surgery, pulmonary, radiology, and oncology to individualize the best staging approach for the patient.

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Author information

Authors and Affiliations

  1. Division of Gastroenterology, Center for Advanced Therapeutic Endoscopy, Lenox Hill Hospital, New York, NY, USA

    David H. Robbins MD, MSc & Babitha Reddy DO, MPH

  2. Department of Gastroenterology and Hepatology, The University of Alabama at Birmingham, Birmingham, AL, USA

    Mohamad A. Eloubeidi MD, MHS (Associate Professor of Medicine and Pathology, Director Endoscopic Ultrasound Program)

Authors
  1. David H. Robbins MD, MSc
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  2. Babitha Reddy DO, MPH
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  3. Mohamad A. Eloubeidi MD, MHS
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Editor information

Editors and Affiliations

  1. Digestive Health Center, University of Virginia Health System, Charlottesville, VA, USA

    Vanessa M. Shami MD (Associate Professor of Medicine Director of Endoscopic Ultrasound) (Associate Professor of Medicine Director of Endoscopic Ultrasound)

  2. Digestive Health Center, University of Virginia Helath System, Charlottesville, USA

    Michel Kahaleh MD (Associate Professor of Medicine Director of Pancreatico-Biliary Services) (Associate Professor of Medicine Director of Pancreatico-Biliary Services)

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Robbins, D.H., Reddy, B., Eloubeidi, M.A. (2010). Role of EUS in Mediastinal Nodes, Masses, Cysts, and Lung Cancer. In: Shami, V.M., Kahaleh, M. (eds) Endoscopic Ultrasound. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-480-7_8

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  • DOI: https://doi.org/10.1007/978-1-60327-480-7_8

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-479-1

  • Online ISBN: 978-1-60327-480-7

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