F. Panelli et al., Evaluation of mediastinal masses by endoscopic ultrasound and endoscopic ultrasound-guided fine needle aspiration, AM J GASTRO, 96(2), 2001, pp. 401-408
OBJECTIVE: Interest has been growing in using endoscopic ultrasound and end
oscopic ultrasound-guided fine needle aspiration in the evaluation of media
stinal masses. The purpose of this study was to review the spectrum of medi
astinal masses encountered using endoscopic ultrasound.
METHODS: We reviewed all cases of mediastinal masses examined by endoscopic
ultrasound, with or without endoscopic ultrasound-guided fine needle aspir
ation, prospectively gathered from our electronic database from April 1995
to July 2000.
RESULTS: Of 1447 upper endoscopic ultrasound examinations, 33 (2.3%) involv
ed a mediastinal mass. Sixty-one percent of the patients were male and the
average age was 65 yr. Fifty-five percent of patients had dysphagia, 48 per
cent experienced weight loss, and only 12 percent were totally asymptomatic
. Seventy-three percent had masses by chest CT. Sixty-seven percent were ul
timately found to be malignant, 21 percent were solid benign lesions, and f
our were cystic. Only two lesions were resected. Endoscopic: ultrasound-gui
ded fine needle aspiration was used in 76 percent of all patients. The medi
an survival of patients with malignant lesions was only 87 days.
CONCLUSIONS: Lesions of the deep mediastinum are often difficult to conclus
ively diagnose with nonendoscopic studies. Endoscopic ultrasound and endosc
opic ultrasound-guided fine needle aspiration can easily access this region
to aid in the diagnosis and management of these lesions.