Ultrasound-Guided Flexible Bronchoscopy for the Diagnosis of Tumor Invasion to the Bronchial Wall and Mediastinum

It is sometimes difficult to evaluate infiltration of lung cancer to parabronchial tissue and intrabronchial wall using computed tomography (CT). Recently ultrasound-guided flexible bronchoscopy (USFB) became available to investigate tumor invasion to the bronchial wall and lymph nodes. To evaluate tumor invasion by USFB, we selected 20 cases from 800 lung cancer patients who presented over a 2-year period (from 1997 to 1999). All 20 cases were ambiguous for invasion and depth of tumor. Four of 7 cases evaluated as carcinoma in situ by chest CT and conventional bronchoscopy were diagnosed as early lung cancer by USFB. The condition of four of the 9 patients initially assessed with no tumor invastion to the aorta was diagnosed by USFB as tumor invasion to the aortic wall. Four cases were surveyed with regard to tracheal invasion. Two cases initially found to have invasion by CT were diagnosed with no infiltration to the tracheal wall by USFB. One case. found to have no invasion by CT. was diagnosed by USFB to have tracheal invasion. In 11 of the 20 patients (55%) examined, the depth of tumor and/or infiltration to aorta or trachea was corrected through the use of USFB. USFB was also helpful in accurately staging lung cancer. Journal of Bronchology7:127-132, 2000. USFB, ultrasound-guided flexible bronchoscopy; CT, computed tomography.