ultrasound-guided cervical lymph node sampling performed by respiratory physicians mohammed ahmed资料.pdf

该【ultrasound-guided cervical lymph node sampling performed by respiratory physicians mohammed ahmed资料 】是由【宝钗文档】上传分享，文档一共【6】页，该文档可以免费在线阅读，需要了解更多关于【ultrasound-guided cervical lymph node sampling performed by respiratory physicians mohammed ahmed资料 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。BiomedHub2019;4:501119DOI:?2019TheAuthor(s)Received:January11,,BaselAcceptedafterrevision:May23,2019Publishedonline:July26,2019monsAttribution-mercial--BY-NC-ND)(vices/essLicense).Usageanddistribu--GuidedCervicalLymphNodeSamplingPerformedbyRespiratoryPhysiciansa,?bcaMohammed?Ahmed?Cyrus?Daneshvar?David?Breen?ab?InterventionalRespiratoryUnit,GalwayUniversityHospital,Galway,Ireland;?TheChestcCentre,AintreeUniversityHospitalsNHSFoundationTrust,Liverpool,UK;?DepartmentofRespiratoryMedicine,UniversityHospitalsPlymouthNHSTrust,Plymouth,UKWhatIsItabout?Somerespiratorydiseasessuchaslungcancerandsarcoidosisareassociatedwithnecklymphade---tivelylookedattheadequacyofultrasound-guidedsamplingofnecklymphnodesperformedbyrespi-%ofcasesandadiagnosiswasmadebasedonthesesamplesin84%·Ultrasound·Biopsy·LungcancerdiagnosisAbstractBackground:(US)hasrevolutionisedrespiratoryinvestigations,andneckultrasound(NUS)isincreasinglyrecognisedasanadditionalimportantskillforre-:WeaimedtoassessthefeasibilityofNUSperformedbyre-:Thisisasingle--guidedcer-,:Over5years,106patientsunderwentNUS-(%[95%–96%]%[95%–%]forradiologists[p=]).Intherespiratoryphysiciangroup,adiagnosiswasachievedbasedonlymphnodesamplingin89cases(84%).,GalwayUniversityHospitalNewcastleRoadGalwayH91YR71(Ireland)E-******@BiomedHub2019;4:5011192DOI:?2019TheAuthor(s).,BaselAhmedetal.:Ultrasound-GuidedCervicalLymphNodeSamplingPerformedbyRespiratoryPhysicianssamplingwastheonlyprocedureperformedtoobtaintissuein48cases(%).Conclusion:-.?2019TheAuthor(s),BaselIntroductionEndobronchialultrasound(EBUS),forinstance,patientswithmediastinallymphadenopathyhavebeenreportedtohavecervicallymphnodeinvolvementin40–50%ofcaseswhenneckultrasound(NUS)wasroutinelyperformed[1,2].ThepresenceofmetastaticdiseasewithinthesupraclavicularlymphnodesrepresentsN3diseaseandM1bdiseaseiftheuppercervicallymphnodesareinvolvedwithamajorimpactontreatmentdecisions[3].Theclinicalandradiologicalassessmentofneckadenopathycansuggestinvolvement;however,,thebasicprinciplesofcancerassessmentadvisesamplingthesiteofdiseasethatprovidesthemostclinicalinformationregardingstaginganddiagnosisinasingleclinicalsetting[4].Moreover,otherconditionsfrequentlyinvestigatedbyrespiratoryphysicianssuchassarcoidosis,tuberculosis,medias-tinallymphadenopathyduetometastaticextrapulmonarymalignancy,andlymphomaarealsoassociatedwithneckadenopathy[5,6].Respiratoryphysiciansareincreasinglyfamiliarwiththeuseofultrasound(US).,--yearperiod(March2013–March2018).--;4:5011193DOI:?2019TheAuthor(s).,BaselAhmedetal.:Ultrasound-(SD),()lymphnodesamplingbyMales,n(%)55()respiratoryphysiciansMeanshortlymphnodediameter(SD),(6)Diagnosisonlymphnodesample,n(%)Lungcancer69()Cancerotherthanlung8()Lymphoma4()Sarcoidosis6()Tuberculosis2()Otherbenign18()Inadequatesampling9()SD,?Otherbenign:–12MHzusingoneoftwomachines(ZonareZoneultramachine[Zonare?,California,USA]andHitachiEUB-7500Amachine[Hitachi,Ltd.,Tokyo,Japan]).Patientswerepositionedinasemi-,,orientedhorizontallyandlatervertically,wasthenmovedcraniallytoassessthelower,middle,anduppercervicalchaintothelevelofthesubman-,,shape,presenceofhilum,necrosis,,basedonUSfeatures[7],%lidocainewasappliedintradermallyandsubcutane--graphicidentificationofthenode,directsamplingusinga22-Gneedlewasperformedwithreal-,2–3coreneedleBs)wereobtainedfromlymphnodesusingan18-GSuperCoreTMneedle(AragonMedicalDevices,Texas,USA).-18(Minitab?StatisticalSoftware,Pennsylvania,USA)%CI,,<;4:5011194DOI:?2019TheAuthor(s).,BaselAhmedetal.:Ultrasound-GuidedCervicalLymphNodeSamplingPerformedbyRespiratoryPhysicians%100p>.?%upperCIofadequacyofneck30lymphnodesamplingperformed20byinterventionalradiologists(IR)andrespiratoryphysicians10(RP).CNB,coreneedlebiopsy;0FNA,“Overall”-yearperiod,(34%)ofthose(meanage65±16years,%males,%)(Table1).Necklymphnodefineneedleaspiration(FNA)Bwereperformedin38patients(%)andFNAonlyin68patients(%).Adiagnosiswasachievedonlymphnodesamplingin89/106cases(84%).,theradiologydepartmentperformed35NUS-guidedlymphnodesamplingprocedureswithafinaldiagnosisofmalignancyin10/35cases(%).CNBwasperformedin5patients(%)andFNAin30patients(%).Therewasnodifferenceinthemeanshortdiameteroflymphnodessampledbyradiologistsandrespiratoryphysicians(±±6mm[p=]).%(95%–96%)%(95%–%)forradiologists(p=).,necklymphnodesamplingwastheonlyprocedureperformedtoobtaintissuein48cases(%).monlyper-formedotherprocedurewasEBUSin26patients(%).Excisionallymphnodebiopsywasperformedin8cases(Table2).Among76patientswithsuspectedmalignancyoncytologicalexaminationtherewassufficientmaterialforimmunohistochemistrystainingin73patients(%).Furthertestingformolecularanalysisorprogrammeddeathligand1(PDL1)wasrequestedin18samplesandwaspossiblein17(%).In1casethepercentageoftumourcellsinthesamplewas10%<;4:5011195DOI:?2019TheAuthor(s).,BaselAhmedetal.:Ultrasound--gradeB-celllymphomaNHLNHLReactivelymphadenopathyCastlemanlymphadenopathyNHLNHLNHLNHLSCLC,smallcelllungcancer;NHL,non-Hodgkin’-guidedsamplingofadenopathyledbyrespi--equacyrate(%)parabletoresultsfromaprevioussystematicreviewofUS-guidedsamplingofnecklesions,%forradiologistsand11%forclinicianswithoutrapidon-siteevaluation(ROSE)[8].Importantly,in14/15(%)casesconfirmedasaprimarylungadenocarcinoma,%%ofthecases[9].IncorporatingNUSdonebyrespiratoryphysiciansasapoint-of-,quickprocedureprovidesearlyconfirmationofcancertypeandstage,whilstpotenti