EBUS may arise as an initial time saving procedure in patients who are suspected to have small cell lung cancer

Small cell lung cancer (SCLC) commonly presents as hilar/mediastinal masses. In some occasions, conventional flexible bronchoscopy fails and a substantial amount of time is lost until establishing the diagnosis.

The aim of the study was to demonstrate the superiority of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) compared to conventional methods in establishing the diagnosis as an initial modality as well as to point out the saved time until the diagnosis.

We retrospectively reviewed the patients who were diagnosed as SCLC by EBUS-TBNA between April 2010 and January 2016. The demographics of the patients, smoking history were all recorded. We also compared the time between the first computed tomography (1stCT) and first diagnostic procedure (1stDP), 1stDP and final diagnosis (FDx), 1stCT and FDx, and 1stDP and EBUS procedure were also compared.

One hundred and thirty-three patients were included in the study. The diagnostic yield of EBUS-TBNA was 98.5%. The mean time between the 1stCT and 1stDP; 1stDP and FDx; 1stCT and FDx; 1stDP and EBUS procedure were 7.0 ± 9.0; 11.8 ± 16.1; 18.8 ± 17.9; and 10.8 ± 16.0 days, respectively. The time between 1stCT to 1stDP was not significantly different in patients with or without previous diagnostic procedures. However, the time between 1stDP to FDx and 1stCT to FDx were significantly higher in the patients with previous procedures (P < .001). The difference in time between 1stDP to FDx and 1stCT to FDx was also similar in patients with only hilar and/or mediastinal lesions (P = .001, P = .006, respectively).

EBUS-TBNA may be an initial diagnostic procedure in SCLC. Patients with only hilar/mediastinal masses without any endobronchial lesion could be directed to centers with the capability for performing EBUS-TBNA to have a rapid diagnosis without any time loss.