An Appraisal of Newer Diagnostic Methods for Intrathoracic Lesions

Endobronchial Ultrasonography

“…Subsequent publications highlighted its utility in the diagnosis of endobronchial and peripheral lesions and the ability of TBNA to provide a diagnosis even in the absence of endobronchial diseases. [27][28][29] The 1991 American College of Chest Physicians bronchoscopy survey, however, reported that TBNA was used routinely in the evaluation of malignant disease by only 11.8% of pulmonologists. 30 This underutilization of TBNA likely reflects a lack of formal training of pulmonary fellows.…”

Transbronchial Needle Aspiration

“…[4][5][6] Carinal lymph node involvement in lung cancer was accepted as a contraindication for surgery by many of these early pioneers. [7][8][9] Bridgman, Duffield, and Takaro used a Vim Silverman needle to perform subcarinal lymph node biopsies and stated their belief nicely: "obtain-ing adequate subcarinal lymphnode material can be of considerable aid in making a diagnosis, in determining the extent of disease, and helping us avoid an unnecessary thoracotomy, particularly in patients who are poor operative risks." 9 Wang and colleagues introduced this technique to North America through the rigid bronchoscope in the early 1980s 1011 and later adapted the technique for FB.…”

Transbronchial needle aspiration staging of bronchogenic carcinoma

“…This method was f'lrst introduced using the rigid bronchoscope [11][12][13][14][15][16][17][18]. The 19] was a prerequisite for the use of the fiberoptic bronchoscope for TBNA [18,20,21].…”