For lung cancer, Lymph Node staging is of paramount importance for the treatment planning process and prognosis.
Lymph Nodes in the chest are oval shaped organs that are linked with lymphatic vessels that carry fluid and cells from a part of the lung that it drains.
These lymph nodes tend to get larger when they carry abnormal cells or bacteria that could indicate an infection or inflammation or in some cases cancer.
This if there is a suspicion for lung cancer then sampling the lymph nodes in the chest may aide in its staging.
Endobronchial Ultrasound (EBUS)
This is a relatively new procedure used in the diagnosis and staging of lung cancer, infections, and other diseases causing enlarged lymph nodes in the chest. It is a minimally invasive procedure that has proven highly effective.
EBUS allows physicians to perform a technique known as transbronchial needle aspiration (TBNA) to obtain tissue or fluid samples from the lungs and surrounding lymph nodes without conventional surgery. The samples can be used for diagnosing and staging lung cancer, detecting infections, and identifying inflammatory diseases that affect the lungs.
Conventionally a diagnostic procedure, known as mediastinoscopy was performed by cardiothoracic surgeons. This was a minor surgical procedure that provided access to the chest with an incision made in the neck just above the breastbone or next to the breastbone. Tissue was then collected via biopsy.
However, using the new endobronchial ultrasound procedure, the physician can perform needle aspiration on lymph nodes using a bronchoscope inserted through the mouth. No incisions are necessary
Benefits of EBUS
Provides real-time imaging of the surface of the airways, blood vessels, lungs, and lymph nodes. The improved images allow the physician to easily view difficult-to-reach areas and to access more, and smaller, lymph nodes for biopsy with the aspiration needle than through conventional mediatinoscopy.
EBUS is performed under moderate sedation or general anesthesia.
Patients recover quickly and can generally go home the same day
Dr Shetty is one of the few pulmonologists in silicon valley who performs this procedure.