Transbronchial Needle Aspiration in the Diagnosis of Submucosal and Peribronchial Bronchogenic Carcinoma

Shure, Deborah; Fedullo, Peter F.

doi:10.1378/chest.88.1.49

Cited by 107 publications

(54 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, besides conventional transbronchial needle aspiration (TBNA), endobronchial ultrasound and endoesophageal ultrasound, and especially the combination of both, are increasingly used worldwide as the primary diagnostic methods [18,19,20,21]. However, this also means that most of the available material is shifted from being histological to cytological.…”

Section: Aspects Of Tumor Samplingmentioning

confidence: 99%

Preparation of Cell Blocks for Lung Cancer Diagnosis and Prediction: Protocol and Experience of a High-Volume Center

et al. 2014

View full text Add to dashboard Cite

Minimally invasive diagnostic techniques are increasingly being used to obtain specimens for pathological diagnosis and prediction. Referring to lung cancer, both endobronchial and endoesophageal ultrasound are used worldwide as diagnostic routine methods. Consequently, an increasing number of pathological samples are cytological and fewer are histological. On the other hand, the requirements for specific and sensitive tumor subtyping complemented by predictive analyses are steadily increasing and are an essential basis for evidence-based treatment decisions. In this article we focus on the cell block method as a helpful tool for diagnostic and predictive analyses in lung cancer and point out its advantages and disadvantages in comparison to conventional cytological and biopsy specimens. Furthermore, we retrospectively analyze the diagnostic results of the cell block method in a high-volume center over 5 years. The main advantages of cell blocks are the availability of established and validated protocols, archiving and the opportunity to have serial sections from the same specimens to provide or repeat molecular analyses. Actually, in case of tumor progression, even additional biomarkers can be tested using the original cell block when re-biopsies are not feasible. The cell block method should be considered as a reliable, complimentary approach to conventional cytological or biopsy procedures, which is helpful to fulfill the increasing requirements of high-quality diagnostics and prediction.

show abstract

Section: Aspects Of Tumor Samplingmentioning

confidence: 99%

Preparation of Cell Blocks for Lung Cancer Diagnosis and Prediction: Protocol and Experience of a High-Volume Center

et al. 2014

View full text Add to dashboard Cite

show abstract

“…6,7 While the mucosal tumor usually presents as exophytic mass within the lumen of a bronchus, the endoscopic evidences of submucosal and peribronchial tumors may be more subtle in presentation, as: erythema, loss of normal bronchial markings, bronchial narrowing, thickening of the mucosal stripes, or extrinsic compression of the bronchus. 4 Although the diagnostic yield of bronchoscopic forceps biopsy is very high for exophytic masses, submucosal or peribronchial disease is more difficult to sample through the standard forceps biopsy. [8][9][10] Bronchial washing and bronchial brushing are two of the conventional diagnostic procedures routinely performed during bronchoscopic sampling.…”

Section: Discussionmentioning

confidence: 99%

“…Sites for sampling were identified by indirect evidences like erythema, extrinsically compressed airway, thickened mucosal stripes, and loss of normal bronchial markings or by intuition from careful review of chest CT scans. 4 To minimize sampling error due to contamination from tracheobronchial secretions, care was taken to collect TBNAs prior to examination of the distal bronchial tree. The needle catheter is introduced through the suction channel and the distal tip of the needle is placed in a position just visible from the end of the bronchoscope to facilitate accurate placement.…”

Section: Protocolmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic yield of conventional transbronchial needle aspiration in suspected bronchogenic carcinoma without intraluminal growth on bronchoscopy

2017

View full text Add to dashboard Cite

Background: Bronchogenic carcinoma with spread along the mucosal plane presents as an exophytic mass. Most of the submucosal and peribronchial patterns of this malignancy are harder to detect by standard diagnostic procedures such as bronchial washing, brushing and forceps biopsy. We sought to investigate the utility of transbronchial needle aspiration (TBNA) in the diagnosis of bronchogenic carcinoma without intraluminal mass, through prospective analysis of routine diagnostic bronchoscopies performed in a 24-month period, at a tertiary care hospital.Methods: Patients with suspected bronchogenic carcinoma (clinical and radiological) underwent standard computed tomography (CT) of thorax. Further the patients were subjected to conventional TBNA, singly, and in combination with bronchial washings and brushings. The results were analyzed statistically for the diagnostic yield of TBNA.Results: Among the 42 patients assessed, 29 had malignancy confirmed by forceps biopsy or CT guided Fine Needle aspiration cytology or biopsy and bronchoscopy. Among them, 17 cases were detected by a combination of the results of bronchial washing, brushing and TBNA. The individual sensitivities amounted to 3.4% (n=1), 51.72% (n=15) and 27.6% (n=8), respectively. There were no false positive results. Concerning different bronchoscopic sampling techniques, 9 cases were diagnosed solely by bronchial brushings and 2 cases by TBNA alone. No periprocedural complications were encountered.Conclusions: Value of bronchial brushing in the diagnosis of bronchogenic carcinoma without bronchoscopically visible intraluminal mass is above that of conventional TBNA. Addition of bronchial washings, to bronchial brushings and TBNA has an insignificant impact on the diagnosis.

show abstract

“…Bronchoscopy with forceps biopsy (FB), bronchial brushing (BB) and bronchial washing (BW) is the most used technique to diagnose central airways neoplasms. Some authors have suggested that the addition of endobronchial needle aspiration (EBNA) to these conventional diagnostic methods may increase the sensitivity of bronchoscopy in submucosal and peribronchial diseases, but few prospective studies have been performed and this procedure is still underutilized in many centers [1,2,3,4,5,6,7,8,9,10]. Rapid on-site evaluation (ROSE) has been shown to improve the sensitivity of transbronchial needle aspiration (TBNA) of mediastinal nodes and pulmonary peripheral lesions, reducing the number of inadequate specimens, costs and complications [11,12,13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Rapid On-Site Evaluation Improves Needle Aspiration Sensitivity in the Diagnosis of Central Lung Cancers: A Randomized Trial

Mondoni¹,

Carlucci²,

Marco³

et al. 2013

Respiration

View full text Add to dashboard Cite

Background: Few prospective studies have evaluated the role of endobronchial needle aspiration in diagnosing central airways neoplasms. Rapid on-site evaluation has long been used in transbronchial needle aspiration of adenopathies and peripheral lesions, but its role in sampling central malignancies has not been substantiated yet. Objectives: In this study we evaluated if endobronchial needle aspiration may increase the sensitivity of bronchoscopy for diagnosing central airways neoplasms when added to conventional diagnostic methods (forceps biopsy, brushing and bronchial washing), and if rapid on-site evaluation may be beneficial in patients undergoing endobronchial needle aspiration. Methods: 125 patients (77% males, aged 70 ± 7 years; mean ± SD) with central lung cancers were randomized to undergo bronchoscopy including conventional diagnostic methods and needle aspiration, with or without rapid on-site evaluation, stratifying the patients on the basis of the neoplasm growth pattern (exophytic and submucosal/peribronchial disease). Results: Needle aspiration significantly increased the sensitivity of bronchoscopy when added to conventional methods (from 76 to 91%; p < 0.001), primarily resulting from differences in submucosal/peribronchial diseases (68 vs. 90%; p < 0.001) and independently from the presence of rapid on-site evaluation; needle aspiration guided by rapid on-site evaluation guaranteed a higher improvement in bronchoscopy sensitivity than conventional needle aspiration (98 vs. 84%, respectively; p = 0.004). Needle aspiration guided by rapid on-site evaluation showed a significantly higher sensitivity than the conventional method (97 vs. 76%, respectively; p = 0.001). Conclusions: Needle aspiration increases the sensitivity of bronchoscopy in diagnosing central airways malignancies when added to conventional diagnostic methods, with a further significant improvement when guided by rapid on-site evaluation.

show abstract

Transbronchial Needle Aspiration in the Diagnosis of Submucosal and Peribronchial Bronchogenic Carcinoma

Cited by 107 publications

References 11 publications

Preparation of Cell Blocks for Lung Cancer Diagnosis and Prediction: Protocol and Experience of a High-Volume Center

Preparation of Cell Blocks for Lung Cancer Diagnosis and Prediction: Protocol and Experience of a High-Volume Center

Diagnostic yield of conventional transbronchial needle aspiration in suspected bronchogenic carcinoma without intraluminal growth on bronchoscopy

Rapid On-Site Evaluation Improves Needle Aspiration Sensitivity in the Diagnosis of Central Lung Cancers: A Randomized Trial

Contact Info

Product

Resources

About