OBJECTIVE:To evaluate the yield and cost effectiveness of transbronchial needle aspiration (TBNA) in the assessment of mediastinal and/or hilar lymphadenopathy. DESIGN: Retrospective study. SETTING: A university hospital. POPULATION STUDIED: Ninety-six patients referred for bronchoscopy with computed tomographic evidence of significant mediastinal or hilar adenopathy. RESULTS: Ninety-nine patient records were reviewed. Three patients had two separate bronchoscopy procedures. TBNA was positive in 42 patients (44%) and negative in 54 patients. Of the 42 patients with a positive aspirate, 40 had malignant cytology and two had cells consistent with benign disease. The positive TBNA result altered management in 22 of 40 patients with malignant disease and one of two patients with benign disease, thereby avoiding further diagnostic procedures. The cost of these subsequent procedures was estimated at $27,335. No complications related to TBNA were documented. CONCLUSIONS: TBNA is a high-yield, safe and cost effective procedure for the diagnosis and staging of bronchogenic cancer.

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JA CROCKET, MR CHAPUT, DC LIEN. Fi bre op tic bron cho scopy in the di ag no sis of pul mo nary dis ease in the im mu no com pro mised host in north ern Al berta. Can J In fect Dis 1995;6(6):286-290. OB JEC TIVES:To de ter mine the di ag nos tic util ity of bron cho scopy in a popu la tion of im mu no com pro mised hosts in north ern Al berta. PA TIENTS AND METH ODS: Re sults from bron cho scopy in 86 im mu no com pro mised pa tients who un der went a to tal of 101 pro ce dures were ret ro spec tively re viewed. RE SULTS:The over all di ag nos tic yield was 57% with the high est yield in pa tients on im mu no sup pres sive drug ther apy (80%) and the low est yield in the group of bone mar row trans plant pa tients (27%). CON CLU SIONS: Bron cho scopy is a valu able tool for the evalua tion of pul mo nary dis ease in the im mu no com pro mised host. Over all di ag nos tic yield of 57% is com pa ra ble with that re ported in the lit era ture. Key Words: Bron choal veo lar lavage, Bron cho scopy, Im mu no com pro mised host, Pneu mo niaBronchoscopie au moyen de la fibre optique dans le diagnostic de la pneumopathie chez l'hôte immunodéficient dans le Nord de l'Alberta OB JEC TIFS : Dé ter mi ner l'u til ité di ag nos tique de la bron cho sco pie au près d'une popu la tion de su jets im mu nodéfi -cients, dans le Nord de l'Al berta. PA TIENTS ET MÉTH ODES : Les résul tats de la bron cho sco pie ef fec tuée chez 86 pa tients im mu nodéfi cients to tali sant 101 in ter ven tions ont été pas sés en re vue. RÉSUL TATS : Dans l'en sem ble, le ren de ment di ag nos tique à été de 57 %, le ren de ment étant le plus fort chez les patients sous traite ment médica men teux im mu no sup presseurs (80 %) et le plus fai ble, chez les pa tients ay ant subi une trans plan ta tion de moelle os seuse (27 %). CON CLU SIONS : La bron cho sco pie est utile pour éval uer la pneu mo pathie chez l'hôte im mu nodéfi cient. Le ren dement di ag nos tique global ob tenu (57 %) se com pare au ren de ment dont fait état la litté ra ture. 286CAN J IN FECT DIS VOL 6 NO 6 NO VEM BER/DE CEM BER 1995