Paul Zarogoulidis, Wolfgang Hofenforst-Schwidt, Haidong Huang, Stavros Tryfon, Yifei Zhang, Guoren Ma, Kyriakos Amarantidis, Elena Maragouli, Vasilis Papadopoulos, Εleni-Isidora Perdikouri, Vagelis Voulgaris, Lutz Freitag, Chrysoula Margioula-Siarkou, Theodora Tsiouda, Paschalis Ntolios, Stamatis Petousis, Konstantina Triantafylopoulou, Kosmas Tsakiridis, Nikolaos Courcoutsakis, Sofia Baka, Dimitris Baloukas, Paschalis Steiropoulos, Bojan Zarić, Xiaping Shen
Introduction: The best tissue sample is still very important for the diagnosis of mesothorax lymphadenopathy. In the past 20 years endobronchial ultrasound (EBUS) has been used efficiently in most cases of primary lung cancer disease or metastatic disease. Several new type of needles have been created such 19G, 18G and hybrid biopsies with cryoprobes. Rapid on-site evaluation (ROSE) is used as an additional initial diagnostic tool. Confocal microscopy is a method of rapid on-site evaluation. Patients and Methods: One hundred patients with mesothorax lymphadenopathy were biopsied with ebus and two groups were created one with rapid on-site evaluation with confocal microscopy and one by an operator with microscopic evaluation with sample preparation on cytoglasses. Our main objective was to assess parameters such as time, false negative results between the two techniques and technical issues such as the accessibility and evaluation between the two techniques. Safety was also evaluated. Results: catheter was less possible in a few cases due to rigid angles within the airways especially for small lymphnodes ≤ 1.5 cm (L4L mainly). Discussion: Confocal is a safe and time-efficient technique for mesothorax lymphadenopathy. A high level of training is required for pulmonary physicians in order to assess the novel imaging technique. Definitely different parts of the lymphnode have to reached and evaluated in order to have a proper initial evaluation.