Apport des nouvelles techniques diagnostiques endoscopiques dans le diagnostic et le bilan d'extension des cancers bronchiques

The diagnostic work-up of peripheral pulmonary nodules and of central pulmonary infiltrates and masses not visible at routine bronchoscopy, as well as that of mediastinal and/or hilar lymph nodes remains a significant challenge. Two new endoscopic tools have been introduced that will potentially change current practice. Electromagnetic navigation of the airways and radial endobronchial ultrasound (EBUS) with guided sampling have increased the yield of conventional flexible bronchoscopy for the diagnosis of peripheral pulmonary nodules. Linear EBUS and endoscopic oesophageal ultrasound (EUS) are minimally invasive techniques that can guide real time needle aspiration of centrally localized masses or infiltrates not visible at routine bronchoscopy, and from hilar or mediastinal lymph nodes, with major implications for the diagnosis and staging of lung cancer.