{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T22:48:46Z","timestamp":1785278926723,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Endosonography (i.e., endoscopic ultrasound with bronchoscope fine-needle aspiration, EUS-B-FNA and endobronchial ultrasound-guided transbronchial needle aspiration, EBUS-TBNA) is a widely used technique in the diagnosis and staging of non-small cell lung cancer. Limited data are available in diagnosing small cell lung cancer (SCLC), and no studies have specifically investigated the diagnostic accuracy of EUS-B-FNA in these patients. The study aims at evaluating the sensitivity and safety of endosonography in the diagnosis of SCLC. Methods: A prospective, single-center, observational study was conducted in Italy. All patients diagnosed with SCLC who underwent EUS-B-FNA and\/or EBUS-TBNA were enrolled. The sensitivity of EUS-B-FNA and EBUS-TBNA were assessed using pathological confirmation as the gold standard. Results: A total of 72 patients (38 (53%) males) with confirmed SCLC were included in the study. EUS-B-FNA was performed in 31 (43%) patients and EBUS-TBNA in 44 (61.1%) patients; both procedures were performed in three (4.2%). The overall sensitivity of endosonography was 97.2%. The sensitivity of EUS-B-FNA and EBUS-TBNA was 96.8% and 90.9%, respectively. No differences were observed in the sensitivity of both techniques when sampling lymph nodes vs. pulmonary parenchymal lesions (p = 0.99). The overall complication rate was 5.6%. No major complications were reported. Conclusions: Endosonography is a highly accurate and safe technique in diagnosing SCLC. EUS-B-FNA alone demonstrates excellent sensitivity, supporting its extensive role as a valuable diagnostic tool. The combined use of both techniques may further optimize diagnostic yield in the diagnosis of SCLC.<\/jats:p>","DOI":"10.3390\/diagnostics16091294","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T19:24:51Z","timestamp":1777317891000},"page":"1294","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Utility and Safety of Endosonography in the Diagnosis of Small Cell Lung Cancer: A Prospective Single-Center Observational Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8484-3661","authenticated-orcid":false,"given":"Carmine","family":"Salerni","sequence":"first","affiliation":[{"name":"Respiratory Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1930-8959","authenticated-orcid":false,"given":"Silvia","family":"Terraneo","sequence":"additional","affiliation":[{"name":"Respiratory Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Bonanomi","sequence":"additional","affiliation":[{"name":"Respiratory Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Mirijaj","sequence":"additional","affiliation":[{"name":"Respiratory Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8548-6019","authenticated-orcid":false,"given":"Cristina","family":"Albrici","sequence":"additional","affiliation":[{"name":"Respiratory Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Carone","sequence":"additional","affiliation":[{"name":"Respiratory Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Gianoncelli","sequence":"additional","affiliation":[{"name":"Oncology Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Moroni","sequence":"additional","affiliation":[{"name":"Oncology Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3304-8417","authenticated-orcid":false,"given":"Umberto","family":"Gianelli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Universit\u00e0 Degli Studi di Milano, 20126 Milan, Italy"},{"name":"Pathology Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Marchi","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, University Hospital of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Carlucci","sequence":"additional","affiliation":[{"name":"Respiratory Unit, ASST Ovest Milanese, 20025 Legnano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9672-3534","authenticated-orcid":false,"given":"Michele","family":"Mondoni","sequence":"additional","affiliation":[{"name":"Respiratory Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy"},{"name":"Department of Health Sciences, Universit\u00e0 Degli Studi di Milano, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.2217\/fon-2022-1315","article-title":"A cross-sectional analysis of treatment patterns in small-cell lung cancer in five European countries","volume":"20","author":"Reguart","year":"2024","journal-title":"Future Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4137\/CMO.S9633","article-title":"Small cell lung cancer doubling time and its effect on clinical presentation: A concise review","volume":"6","author":"Harris","year":"2012","journal-title":"Clin. Med. Insights Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.annonc.2021.03.207","article-title":"Small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up\u2606","volume":"32","author":"Dingemans","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2220","DOI":"10.1056\/NEJMoa1809064","article-title":"First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer","volume":"379","author":"Horn","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S1470-2045(20)30539-8","article-title":"Durvalumab, with or without tremelimumab, plus platinum\u2013etoposide versus platinum\u2013etoposide alone in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): Updated results from a randomised, controlled, open-label, phase 3 trial","volume":"22","author":"Goldman","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1056\/NEJMoa2404873","article-title":"Durvalumab after Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer","volume":"391","author":"Cheng","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.ccell.2020.12.014","article-title":"Patterns of transcription factor programs and immune pathway activation define four major subtypes of SCLC with distinct therapeutic vulnerabilities","volume":"39","author":"Gay","year":"2021","journal-title":"Cancer Cell"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1148\/rg.346140178","article-title":"Small cell lung carcinoma: Staging, imaging, and treatment considerations","volume":"34","author":"Carter","year":"2014","journal-title":"Radiographics"},{"key":"ref_9","first-page":"E439","article-title":"Ultrasound techniques in the evaluation of the mediastinum, part 2: Mediastinal lymph node anatomy and diagnostic reach of ultrasound techniques, clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography","volume":"7","author":"Jenssen","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1159\/000524398","article-title":"Accuracy and Predictors of Success of EUS-B-FNA in the Diagnosis of Pulmonary Malignant Lesions: A Prospective Multicenter Italian Study","volume":"101","author":"Mondoni","year":"2022","journal-title":"Respiration"},{"key":"ref_11","first-page":"13","article-title":"Choose the best route: Ultrasound-guided transbronchial and transesophageal needle aspiration with echobronchoscope in the diagnosis of mediastinal and pulmonary lesions","volume":"106","author":"Mondoni","year":"2015","journal-title":"Minerva Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.4187\/respcare.06047","article-title":"Ultrasonography of the mediastinum: Techniques, current practice, and future directions","volume":"63","author":"Fuso","year":"2018","journal-title":"Respir. Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2362995","DOI":"10.1080\/20018525.2024.2362995","article-title":"Added value of EUS-B-FNA to bronchoscopy and EBUS-TBNA in diagnosing and staging of lung cancer","volume":"11","author":"Issa","year":"2024","journal-title":"Eur. Clin. Respir. J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"B\u00e9chade, D. (2025). Clinical Utility of Endoscopic Ultrasound (EUS) and Endobronchial Ultrasound (EBUS) in the Evaluation of Mediastinal Lymphadenopathy. Diagnostics, 15.","DOI":"10.3390\/diagnostics15030349"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1378\/chest.14-1283","article-title":"Transbronchial vs transesophageal needle aspiration using an ultrasound bronchoscope for the diagnosis of mediastinal lesions: A randomized study","volume":"147","author":"Oki","year":"2015","journal-title":"Chest"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.athoracsur.2010.03.106","article-title":"Lymph Node Staging by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Patients With Small Cell Lung Cancer","volume":"90","author":"Wada","year":"2010","journal-title":"Ann. Thorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.resinv.2013.11.004","article-title":"Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of small cell lung cancer","volume":"52","author":"Murakami","year":"2014","journal-title":"Respir. Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.2169\/internalmedicine.55.6082","article-title":"The utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with small-cell lung cancer","volume":"55","author":"Kang","year":"2016","journal-title":"Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1111\/crj.12556","article-title":"EBUS may arise as an initial time saving procedure in patients who are suspected to have small cell lung cancer","volume":"12","author":"Ozturk","year":"2018","journal-title":"Clin. Respir. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1111\/j.1440-1843.2009.01590.x","article-title":"Transoesophageal needle aspiration using a convex probe ultrasonic bronchoscope","volume":"14","author":"Hwangbo","year":"2009","journal-title":"Respirology"},{"key":"ref_21","unstructured":"International Academy of Cytology, International Agency for Research on Cancer, and World Health Organization Joint Editorial Board (2022). WHO Reporting System for Lung Cytopathology, International Agency for Research on Cancer (IARC). [1st ed.]."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/1097-0142(20001025)90:5<279::AID-CNCR3>3.0.CO;2-D","article-title":"Small cell carcinoma versus other lung malignancies: Diagnosis by fine-needle aspiration cytology","volume":"90","author":"Delgado","year":"2000","journal-title":"Cancer Cytopathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1002\/dc.24608","article-title":"The role of cytology in endobronchial ultrasound-guided transbronchial needle aspiration: A study of 813 cases focusing on diagnostic yield, an analysis of misdiagnosed cases and diagnostic accordance rate of cytological subtyping","volume":"49","author":"Ren","year":"2021","journal-title":"Diagn. Cytopathol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1097\/JTO.0b013e31820b86cb","article-title":"Accuracy of fine needle aspiration cytology in the pathological typing of non-small cell lung cancer","volume":"6","author":"Nizzoli","year":"2011","journal-title":"J. Thorac. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1016\/j.hlc.2018.08.015","article-title":"Natural History of Persistent Pulmonary Subsolid Nodules: Long-Term Observation of Different Interval Growth","volume":"28","author":"Tang","year":"2019","journal-title":"Heart Lung Circ."},{"key":"ref_26","unstructured":"Expert Panel on Interventional Radiology, Gilyard, S., Ahmed, O., Kim, C.Y., Chundury, A., Donnelly, E.F., Knavel Koepsel, E.M., Lin, J., Makary, M.S., and Mehta, P. (2026). ACR Appropriateness Criteria\u00ae Radiologic Management of Pulmonary Nodules and Masses: Update 2025. J. Am. Coll. Radiol., in press."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1136\/postgradmedj-2016-134171","article-title":"Oesophagopleural fistula demonstrated by videofluoroscopic swallowing study","volume":"92","author":"Wu","year":"2016","journal-title":"Postgrad. Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.gie.2015.03.1973","article-title":"Endosonography-related mortality and morbidity for pulmonary indications: A nationwide survey in the Netherlands","volume":"82","author":"Annema","year":"2015","journal-title":"Gastrointest. Endosc."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/9\/1294\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T19:50:52Z","timestamp":1777319452000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/9\/1294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,26]]},"references-count":28,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["diagnostics16091294"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16091294","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,26]]}}}