The real value of endobronchial ultrasound

dc.contributor.authorVorster, Morne Johanen_ZA
dc.contributor.authorSchubert, Pawel Tomaszen_ZA
dc.contributor.authorKoegelenberg, Coenraad Frederik Nicolaasen_ZA
dc.identifier.citationVorster, M. J., Schubert, P. T. & Koegelenberg, C. F. N. 2015. The real value of endobronchial ultrasound. South African Medical Journal, 105(10):876, doi:10.7196/SAMJnew.8788
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.descriptionCITATION: Vorster, M. J., Schubert, P. T. & Koegelenberg, C. F. N. 2015. The real value of endobronchial ultrasound. South African Medical Journal, 105(10):876, doi:10.7196/SAMJnew.8788.
dc.descriptionThe original publication is available at
dc.description.abstractEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become a standard procedure worldwide, used in conjunction with bronchoscopy to obtain biopsies for mediastinal disorders. A 67-year-old man with a 40 pack-year smoking history presented with a 2-year history of hoarseness and weight loss. He also had a history of asbestos exposure. On examination under anaesthesia a lesion of the right false vocal fold was found and histology showed a moderately differentiated infiltrating keratinising squamous carcinoma. The question posed was whether this mass could be ascribed to metastatic supraglottic carcinoma or if it was indeed a metachronous primary bronchus carcinoma, as the treatment of these two malignancies differs significantly. Traditional bronchoscopy with TBNA is the least invasive procedure to obtain a cytological diagnosis, but the proximity of the aorta and pulmonary arteries and the mass being 14 mm from the bronchus would have made sampling by means of this procedure near impossible. We used EBUS to localise the mass and noted the position of the major vessels on Doppler ultrasound. Real-time ultrasound guidance allowed us to bridge the tissue plane between the mass and bronchial lumen using the longer EBUS needle and to obtain a fine-needle aspirate of the mass, which proved to be a keratinising squamous carcinoma. We describe this case in which EBUS-TBNA was pivotal in reducing the number of invasive procedures in a patient with metastatic supraglottic carcinoma.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Geen opsomming beskikbaaraf_ZA
dc.format.extent3 pages : illustrationsen_ZA
dc.publisherHealth and Medical Publishing Groupen_ZA
dc.subjectBronchial provocation testsen_ZA
dc.subjectAspiration biopsyen_ZA
dc.subjectCytologic diagnosisen_ZA
dc.titleThe real value of endobronchial ultrasounden_ZA
dc.description.versionPublisher's version
dc.rights.holderHealth & Medical Publishing Groupen_ZA

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