Education and experience improve transbronchial needle aspiration performance.

Haponik, Edward F.; Cappellari, James O.; Chin, Robert; Adair, Norman E.; Lykens, Michael; Alford, P T; Bowton, David L.

doi:10.1164/ajrccm.151.6.7767550

Cited by 104 publications

(53 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the USA, only 54% of pulmonologists used TBNA in 2000, and this low percentage was mainly attributed to the perceived difficulty of this technique [21]. The results of this survey were further confirmed by another trial in which the successful yield of TBNA could only be increased from 21.4 to 47.6% after a 3-yr period of training [22]. Conversely, the accuracy of EBUS-TBNA in mediastinal staging in lung cancer could be as high as 89% for the first 20 cases [23].…”

Section: Ebus-tbna In Sarcoidosis Diagnosismentioning

confidence: 75%

Endobronchial ultrasound: new insight for the diagnosis of sarcoidosis

Wong¹,

Yasufuku²,

Nakajima³

et al. 2007

European Respiratory Journal

233

204

View full text Add to dashboard Cite

A diagnosis of sarcoidosis should be substantiated by pathological means in order to thoroughly exclude other diseases. The role of real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of sarcoidosis has not been reported. The purpose of the present study is to evaluate the diagnostic yield of EBUS-TBNA in demonstrating the pathological features of sarcoidosis.In total, 65 patients with suspected sarcoidosis, with enlarged hilar or mediastinal lymph nodes on computed tomography, were included in the study. Patients with a suspected or known malignancy or previously established diagnosis of sarcoidosis were excluded. Convex probe endobronchial ultrasonography integrated with a separate working channel was used for EBUS-TBNA. Surgical methods were performed in those in whom no granulomas were detected by EBUS-TBNA. Patients were followed up clinically.EBUS-TBNA was performed on a total of 77 lymph node stations in 65 patients. A final diagnosis of sarcoidosis was made for 61 (93.8%) of the patients. The remaining four patients were diagnosed as having Wegener's granulomatosis (n51) or indefinite (n53). In patients with a final diagnosis of sarcoidosis, EBUS-TBNA demonstrated noncaseating epithelioid cell granulomas in 56 (91.8%) of the patients. No complications were reported.Endobronchial ultrasound-guided transbronchial needle aspiration proved to be a safe procedure with a high yield for the diagnoses of sarcoidosis.

show abstract

Section: Ebus-tbna In Sarcoidosis Diagnosismentioning

confidence: 75%

Endobronchial ultrasound: new insight for the diagnosis of sarcoidosis

Wong¹,

Yasufuku²,

Nakajima³

et al. 2007

European Respiratory Journal

233

204

View full text Add to dashboard Cite

show abstract

“…One reason might be that a negative TBNA result can have a variety of causes, such as inadequate puncture technique or suboptimal sample preparation and analysis [17]. Secondly, TBNA has a sensitivity of only 76-80% in the best hands under study conditions [10,19,20], which means that a negative result is of limited value even when established with a high number of aspirates.…”

Section: Number Of Transbronchial Aspirates Ah Diacon Et Almentioning

confidence: 99%

“…It is well known that TBNA has a higher yield in neoplastic than in benign lesions, as well as in small cell lung cancer (SCLC) compared with nonsmall cell lung cancer (NSCLC) [3,16]. Other predictors of positive aspirates are greater size of lymph nodes, infracarinal or right tracheobronchial position, visible mucosal abnormalities, such as a widened carina or erythema, and endobronchial mass lesions [1,3,9,10,17]. It is unknown whether these parameters also predict a higher yield when fewer aspirates are performed at these sites.…”

mentioning

confidence: 99%

Transbronchial needle aspirates: how many passes per target site?

Diacon¹,

Schuurmans²,

Theron³

et al. 2006

European Respiratory Journal

View full text Add to dashboard Cite

Transbronchial needle aspiration is a bronchoscopic sampling method for a variety of bronchial and pulmonary lesions. The present study investigated whether and how serial needle passes contribute to the yield of transbronchial needle aspiration at specific target sites.A total of 1,562 needle passes, performed at 374 target sites in 245 patients with neoplastic disease (82%), non-neoplastic disease (15%) or undiagnosed lesions (3%), were prospectively recorded and rated for anatomical location, size, bronchoscopic appearance and underlying disease.Positive aspirates were obtained in 75% of patients and at 68% of target sites. A diagnosis was established with the first, second, third and fourth needle pass at 64, 87, 95 and 98% of targets, respectively. The absolute yield varied strongly with target site features, but the stepwise increment to the maximum yield provided by serial passes was similar across target sites.In conclusion, three transbronchial needle passes per site are appropriate when only a tissue diagnosis is sought and when alternative sites or sampling modalities are available. At least four or five passes should be carried out at lymph node stations critical for the staging of lung cancer.

show abstract

“…TBNA is a safe and effective method of obtaining cores of tissue for the histological diagnosis of benign and malignant disease in the mediastinal and hilar lymph nodes, and for staging malignant disease [9,10,[17][18][19][20][21][22][23][24]. Some authorities suggest that TBNA may become the procedure of choice for the diagnosis of stage I and II sarcoidosis [17,19].…”

mentioning

confidence: 99%

Bronchoscopic diagnosis of sarcoidosis

Leonard¹,

Tormey²,

O'Keane³

et al. 1997

Eur Respir J

View full text Add to dashboard Cite

Transbronchial lung biopsy (TBLB), transbronchial needle aspiration (TBNA) of mediastinal lymph nodes and bronchoalveolar lavage (BAL) are routinely performed at fibreoptic bronchoscopy. Up to the present time, no data have been available on the efficacy of performing all three of these procedures simultaneously in the bronchoscopic work-up of sarcoidosis. A prospective study was undertaken to compare the diagnostic yield from TBLB, TBNA and BAL in patients presenting with clinical and radiological features typical of sarcoidosis. Thirteen consecutive patients with clinical and radiological features consistent with stage I and II sarcoidosis underwent bronchoscopy with TBLB, TBNA and BAL. Noncaseating granulomata (stain and culture negative for tuberculosis bacilli and fungi) were found in seven of the 13 patients by TBLB, and in six of the 13 patients by TBNA (of which four patients had negative TBLB). Eight of the 13 patients had classical "sarcoid" BAL findings, i.e. >12% lymphocytes, and high CD4+:CD8+ lymphocyte ratio. Combining TBLB, TBNA and BAL gave a diagnostic sensitivity of 100% (12 out of 12 patients) for sarcoidosis. The remaining patient had nondiagnostic bronchoscopic studies and mediastinoscopy biopsy showed a non-Hodgkin's lymphoma. Our data suggest that performing simultaneous transbronchial lung biopsy, transbronchial needle aspiration and bronchoalveolar lavage produces optimal results in the diagnosis of sarcoidosis.

show abstract

Education and experience improve transbronchial needle aspiration performance.

Cited by 104 publications

References 13 publications

Endobronchial ultrasound: new insight for the diagnosis of sarcoidosis

Endobronchial ultrasound: new insight for the diagnosis of sarcoidosis

Transbronchial needle aspirates: how many passes per target site?

Bronchoscopic diagnosis of sarcoidosis

Contact Info

Product

Resources

About