Transbronchial Needle Aspiration for Histology Specimens

Mehta, Atul C.; Kavuru, Mani S.; Meeker, David P.; Gephardt, Gordon N.; Nunez, Carlos

doi:10.1378/chest.96.6.1228

Cited by 120 publications

(76 citation statements)

References 20 publications

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“…Complications were few and minor, requiring no specific treatment. This is in agreement with the findings in other studies using large diameter biopsy needles [10,11,14,15]. Relatively more node specimens of good quality were obtained in patients with advanced T-category.…”

Section: Discussionsupporting

confidence: 92%

“…Using that technique, SHURE and FEDULLO [12] had no false positives, but obtained a sensitivity of only 15%. Other studies of punctures through the flexible bronchoscope do not mention surgical control of the results [11,13,14]. The low but undeniable risk of false positive results and the lower yield with flexible bronchoscopic techniques prompted us to use the Schiessle-needle through a rigid bronchoscope.…”

Section: Discussionmentioning

confidence: 99%

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Transcarinal needle aspiration biopsy in the staging of lung cancer

Vansteenkiste¹,

Lacquet²,

Demedts³

et al. 1994

Eur Respir J

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T Tr ra an ns sc ca ar ri in na al l n ne ee ed dl le e a as sp pi ir ra at ti io on n b bi io op ps sy y i in n t th he e s st ta ag gi in ng g o of f l lu un ng g c ca an nc ce er r Eighty lung cancer patients with subcarinal lymph nodes visible on computed tomography (CT) scan were studied. Specimens were of histological quality (i.e. lymph node tissue) in 59 out of 80 (74%) patients, and showed malignant invasion of this lymph node tissue in 43 cases. Specimens of cytological quality (i.e. lymph node cells) were obtained in 13 out of 80 (16%) patients, and showed malignancy in 7 cases. Therefore, adequate evaluation of the subcarinal lymph nodes was possible in 72 out of 80 (90%) patients. In 50 of these 72, malignant mediastinal spread was proven, and further invasive surgical staging could be avoided. Subgroup analysis showed that this outcome tended to be more likely in patients with abnormal endoscopic appearance of the main carina, with locally extensive tumours, and with nonsquamous histology.These results indicate that transbronchial needle aspiration biopsy of subcarinal lymph nodes can be a valuable alternative to more invasive surgical staging in patients selected by CT scan.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Transcarinal needle aspiration biopsy in the staging of lung cancer

Vansteenkiste¹,

Lacquet²,

Demedts³

et al. 1994

Eur Respir J

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“…The 17% prevalence of mediastinal lymph node metastases in the present study is similar to that of surgical studies evaluating patients with negative mediastinal CT. (20) Data are presented as n or n (%).…”

Section: Discussionmentioning

confidence: 99%

“…Transbronchial needle aspiration was performed under real-time ultrasound control. Needle punctures were performed using the ''jabbing'' method [20]. Integrated colour power Doppler ultrasound was used to avoid intervening vessels immediately before needle puncture ( fig.…”

Section: Ebus-tnbamentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically normal mediastinum

Herth

Ernst²,

Eberhardt³

et al. 2006

Eur Respir J

281

161

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Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can sample enlarged mediastinal lymph nodes in patients with nonsmall cell lung cancer (NSCLC). To date, EBUS-TBNA has only been used to sample nodes visible on computed tomography (CT). The aim of the present study was to determine the accuracy of EBUS-TBNA in sampling nodes f1 cm in diameter.NSCLC patients with CT scans showing no enlarged lymph nodes (no node .1 cm) in the mediastinum underwent EBUS-TBNA. Identifiable lymph nodes at locations 2r, 2l, 4r, 4l, 7, 10r, 10l, 11r and 11l were aspirated. All patients underwent subsequent surgical staging. Diagnoses based on aspiration results were compared with those based on surgical results.In 100 patients (mean age 58.9 yrs; 68 males), 119 lymph nodes ranging 5-10 mm in size were detected and sampled. Malignancy was detected in 19 patients but missed in two; all diagnoses were confirmed by surgical findings. The mean diameter of the punctured lymph nodes was 8.1 mm. The sensitivity of EBUS-TBNA for detecting malignancy was 92.3%, specificity was 100%, and the negative predictive value was 96.3%. No complications occurred.In conclusion, endobronchial ultrasound-guided transbronchial needle aspiration can accurately sample even small mediastinal nodes, therefore avoiding unnecessary surgical exploration in one out of six patients who have no computed tomography evidence of mediastinal disease. Potentially operable patients with no signs of mediastinal involvement on computed tomography may benefit from pre-surgical endobronchial ultrasound-guided transbronchial needle aspiration and staging.

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“…Transbronchial needle aspiration (TBNA) is a wellestablished technique that allows sampling of parabronchial and paratracheal lymph nodes (1,2). Recently, the indications for TBNA have been extended to the sampling of hilar and mediastinal lymph nodes with the development of flexible cytology needles.…”

mentioning

confidence: 99%