Conventional TBNA with 19 G TBNA Needle in Diagnosis of Mediastinal Lymph Nodes – Diagnostic Yield and Safety with 19G TBNA Needle

Abstract

Introdution: As the practice of TBNA becomes more widely accepted, it has also revived a longstanding question on the optimum size of needle and whether larger needle with core biopsy is of any additional benefit. In routine practice 19G needle is rarely used even in large nodes as it is perceived to be technically difficult and likely to give a poor yield of representative tissue. We report our experience with yield and safety using 19G needle for Conventional TBNA. Material and methods: Eighteen patients with large mediastinal nodes (short axis > 25 mm) underwent 19G Conventional TBNA and station 4R and/or stations 7 were punctured respectively. Results: Out of Eighteen patients, core biopsy material was inadequate or unrepresentative in 14 / 18 cases and cytology material was unrepresentative in 2 patients. A diagnosis was reached in 16 of 18 patients by smear cytology and in 14 cases by histology. Out of eighteen patients, 12 patients had Granulomatous etiology, 2 had poorly differentiated adenocarcinoma, 1 had Malignant Round Cell Tumor, and one patient had reactive lymphadenitis. Conclusion: The 19G TBNA procedure is effective and safe, and can be a cost-saving alternative to surgical mediastinal exploration. It should be performed after careful case selection during initial diagnostic bronchoscopy and familiarization with the technique should not be neglected in training programmes and workshops.

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