Endobronchial ultrasonography in bronchoscopic occult pulmonary lesions

Introduction: The diagnostic yield of flexible bronchoscopy for peripheral pulmonary lesions is variable and often limited. Endobronchial ultrasonography (EBUS) has been reported to help localize a bronchoscopic occult pulmonary lesion and thereby improve the diagnostic yield of transbronchial biopsy (TBB). Methods: We evaluated the yield of EBUS-guided TBB in 50 consecutive patients with a bronchoscopic occult pulmonary lesion. Results: The mean diameter of the lesions was 36.6 mm (SD = 19.7 mm). We could visualize 74% of the bronchoscopic occult lesions with EBUS, and in these patients, a histologic diagnosis on TBB was obtained in 84%. However, the diagnostic yield was very poor for lesions <20 mm. Conclusion: EBUS-guided TBB is effective for localizing and diagnosing bronchoscopic occult pulmonary masses >= 20 mm, but its yield remains unsatisfactory for lesions <20 mm.