Transbronchial Needle Aspiration of Diseased Mediastinal Lymph Nodes: Predictors of Positive Findings

Fernández-Villar, Alberto; Iglesias, F.; Mosteiro, Mar; Corbacho, Diego Pereiro; González, A.; Blanco, P.; Paz-Esquete, J.; Bandrés, R.; Piñeiro, Luis

doi:10.1016/s1579-2129(06)60259-0

Cited by 4 publications

(14 citation statements)

References 28 publications

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“…Similar results were obtained in four out of seven studies, involving patients with suspected/known lung cancer [20,21,22,25]. The remaining studies reported no significant difference in TBNA sensitivity depending on the lymph node sizes [34,35,36].…”

Section: Resultssupporting

confidence: 78%

“…Station 7 was reported as the main predictor in three studies [16,17,18], station 4R in two studies [17,19], hilar stations in two studies [20,21], station 3p in one study [22] and station 4 (4R + 4L) in three studies [16,23,24]. Two studies [25,26] did not find any significant statistical difference. Six studies analyzed lymph node station as the predictor in patients with suspected sarcoidosis [27,28,29,30,31,32], but each one reported different results and the only investigation reporting statistical analysis showed no difference among the stations sampled [30].…”

Section: Resultsmentioning

confidence: 99%

“…The presence of abnormal endoscopic appearance was evaluated in nine studies [5,8,10,12,18,25,34,41,49], and six identified it as a relevant predictor.…”

Section: Resultsmentioning

confidence: 99%

“…Out of twelve studies, six reported small cell type as the best predictor [21,24,25,40,45,49], two identified non-small cell [18,23] and four did not detect any statistically significant difference in TBNA accuracy according to cell subtype [7,26,34,51]. …”

Section: Resultsmentioning

confidence: 99%

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Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

et al. 2013

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Background: Transbronchial needle aspiration (TBNA) is a safe and useful sampling technique for the diagnosis of mediastinal adenopathies/masses, but its accuracy seems to be influenced by selected clinical and procedural aspects. Objectives: We performed a systematic review to identify the main predictors of a successful transbronchial aspirate according to different clinical settings. Methods: We searched Medline and Embase for all studies evaluating predictors of TBNA diagnostic yield, published up to February 2012. Two authors reviewed all titles/abstracts and retrieved the full text of articles that are potentially relevant to identify studies according to predefined selection criteria. The methodological quality of studies was assessed through the revised Quality Assessment of Diagnostic Accuracy Studies tool. Evidence synthesis was graded according to overall number of studies, patients involved and methodological features. Results: Fifty-three studies, involving more than 8,000 patients and evaluating 23 potential predictive factors, were included. Major predictors in an unselected population, as well as in patients with suspected/known lung cancer, included lymph node size (short axis length ≥2 cm), presence of abnormal endoscopic findings, subcarinal and right paratracheal location, and the use of histological needle by an experienced bronchoscopist. Stage I and sampling of more than one lymph node stations were the only predictors of a successful TBNA result in patients with suspected sarcoidosis. Conclusions: The diagnostic yield of TBNA depends on selected clinical and procedural features. Knowledge of factors that predict a positive TBNA result may help optimize the diagnostic success of the procedure in different clinical settings.

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Section: Resultssupporting

confidence: 78%

Section: Resultsmentioning

confidence: 99%

“…The presence of abnormal endoscopic appearance was evaluated in nine studies [5,8,10,12,18,25,34,41,49], and six identified it as a relevant predictor.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

et al. 2013

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“…In 15-25% of TBNAs, a representative sample is obtained but a specific diagnosis cannot be made because lymph node enlargement could also occur due to reactive lymph node hyperplasia without actual infiltration of the lymph node by tumour cells [18,14].…”

Section: Discussionmentioning

confidence: 99%

Role of Transbronchial Needle Aspiration in Patients with Thoracic Lymphadenopathy on CT Scan

Mukul¹

2013

AJIM

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Abstract:Context: Transbronchial needle aspiration (TBNA) is a method in which an aspirating needle is used to obtain diagnostic samples from a peribronchial or submucosal lesion through a rigid [1] or flexible bronchoscope [2]. Though it is a very useful bronchoscopic technique it still remains underutilized [3]. Aims: This study was done to evaluate the sensitivity, complication rates and factors affecting the outcome of TBNA. Settings and Design: Prospective trial of fifty two patients with mediastinal lymphadenopathy on CT scan attending Respiratory Diseases Clinic of Jawaharlal Nehru Medical College Hospital. Methods and Material: We analyzed the outcome of TBNA in fifty two patients who underwent TBNA between 2010 and 2012. Sensitivity of TBNA was calculated and factors affecting the TBNA results were analyzed. Statistical analysis used:Chi square test was used for analyzing the factors affecting TBNA results. SPSS Statistics 17.0 was used for analysis. Results: The overall sensitivity of TBNA was found to be 59.6% and it was the only diagnostic technique in 47.6% of the patients. Factors associated with diagnostic acquisition of samples were lymph node size more than 1.5 cm and the presence of indirect signs on bronchoscopy. Conclusions: The sensitivity of TBNA is high in malignant mediastinal lymphadenopathy. Complications occurred in four patients who had self limited bleeding at the site of puncture which healed spontaneously. Important factors predicting the outcome of TBNA are lymph node size and the presence of indirect signs on bronchoscopy. We would recommend this procedure for detection of metastatic lymph nodes in patients with lung cancer and also for mediastinal tubercular lymphadenopathy where diagnosis could not be achieved by less invasive methods.

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Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of small cell lung cancer

Murakami

Oki

Sasaki

et al. 2014

Respiratory Investigation

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Transbronchial Needle Aspiration of Diseased Mediastinal Lymph Nodes: Predictors of Positive Findings

Cited by 4 publications

References 28 publications

Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

Role of Transbronchial Needle Aspiration in Patients with Thoracic Lymphadenopathy on CT Scan

Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of small cell lung cancer

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