Flexible Transbronchial Needle Aspiration for the Diagnosis of Sarcoidosis

Wang, Ko Pen; Johns, Carol J.; Fuenning, Charles; Terry, Peter B.

doi:10.1177/000348948909800412

Cited by 72 publications

(46 citation statements)

References 10 publications

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“…ACCP 2013 guideline for lung cancer found a mean pooled sensitivity of C-TBNA as 78%, ranging from 14 to 100% in terms of lung cancer (3). Studies including patients with suspicion of sarcoidosis have diagnostic sensitivities ranging from 72 to 90% (10)(11)(12). In a study including 34 patients, C-TBNA revealed a definite diagnosis in 14 patients (41.1%) and C-TBNA had a higher DY for malignancy (64.7%) compared to non-malignant diseases (17.6%) (13).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients

Öztürk¹,

Sandal

Karahan³

et al. 2016

Tuberk Toraks

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SUMMARY Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients Introduction: Conventional transbronchial needle aspiration biopsy (C-TBNA) is a technique in evaluating mediastinal/hilar lymph nodes (LN). We aimed to investigate diagnostic yield (DY) and safety of C-TBNAs performed in a single university clinic. Patients and Methods: We retrospectively reviewed 363 consecutive C-TBNA procedures in 219 patients. The DY and its relationship with location, shortest diameter, SUVmax of LN, and number of sampled stations were evaluated.Results: Procedures were diagnostic in 257 (71%) LNs. The most common diagnoses were malignancy (n= 109.30%) and granulomatous inflammation (n= 68, 18.7%) biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients INTRODUCTIONTransbronchial needle aspiration (TBNA) is a minimally invasive technique for lymph node (LN) sampling to investigate etiologies of mediastinal and hilar LNs. Although TBNA was firstly described in 1949, fiberoptic bronchoscopic application was defined in 1981 (1,2). Besides conventional usage with white light bronchoscopy (C-TBNA), its bronchoscopic appliance can also be guided by newer imaging methods like endobronchial ultrasound (EBUS-TBNA).Conventional TBNA is a minimally invasive, safe, and cost-effective technique in evaluating mediastinal and enlarged LNs. Emergence and increasing use of EBUS-TBNA provided more information about this newer technique's diagnostic success and gave the opportunity to compare it with that of C-TBNA. The meta-analyses performed for the 3 rd edition of American College of Chest Physicians (ACCP) Diagnosis and Management of Lung Cancer Guideline yielded mean pooled sensitivities of 78% and 89% for C-TBNA and EBUS-TBNA, respectively (3). There are randomized trials with results suggesting better diagnostic results with EBUS-TBNA in both lung cancer and sarcoidosis patients (4-6). Despite better diagnostic results of TBNA with additional imaging, requirement for advanced devices, special equipment and experienced staff for the specific procedure makes wide range application of those techniques uneasy (7). Thus, C-TBNA may still be important for LN sampling in terms of feasibility and practicality. Herein we report the diagnostic yield (DY) and safety of C-TBNA performed in a single center at a university clinic. PATIENTS and METHODS PatientsThe study included 363 consecutively performed C-TBNA procedures in 219 patients who underwent fiberoptic bronchoscopy and C-TBNA in the Bronchoscopy Unit of Hacettepe University Adult Hospital between October 1 st , 2012 and December 31 st , 2014. With the retrospective design, the study was approved by Hacettepe University Non-interventional Clinical Researches Ethical Committee. The files of the patients were reviewed retrospectively and available study forms were duly filled in. The age, gender, radiological findings, bronchoscopic findings, sampled...

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Section: Discussionmentioning

confidence: 99%

Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients

Öztürk¹,

Sandal

Karahan³

et al. 2016

Tuberk Toraks

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“…The patients usually undergo transbronchial parenchymal tissue biopsy and one study has shown these biopsies to have a diagnostic adequacy of 70% with sensitivity increasing with higher number of samples (14). Many studies have shown that the conventional TBFNAC method has similar adequacy rates, and there are reports of high sensitivity rates such as 90% (15)(16)(17)(18)(19). The biggest advantage of TBFNAC method when compared with transbronchial parenchymal tissue biopsy method is that the morbidity rate is low and potential complications such as pneumothorax and bleeding are encountered less often.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic value of transbronchial needle aspiration cytology in sarcoidosis

Özbudak

Özbilim²,

Özbudak³

et al. 2011

TJPATH

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“…Hem mediastinoskopi gibi invaziv bir işlemin aksine ayaktan takip edilen hastalara uygulanabilir olması hem de mediastinal lenf bezlerinin yanı sıra hiler lenf bezlerinden de örnekleme yapılmasına fırsat sağlaması bakımından oldukça avantajlı bir yöntem hâline gelmiştir. 11,17,25,[34][35][36] Diğer taraftan, mediastinoskopideki kadar büyük biyopsi materyali alınamadığı için tanısallığı sitoloğun tecrübesine de bağlıdır. TBİA tanısallığı ile ilişkili olarak yapılan çalışmalarda endobronşiyal ultrasonografi (EBUS) eşliğinde alınan biyopsilerin tanı oranları daha yüksek bulunmuş olup, farklı çalış-malarda %60,9-90,3 arasında saptanmıştır.…”

Section: Bulgularunclassified

The Relationship Between Diagnostic Efficiency of Bronchoscopy with Clinical and Radiological Findings in Pulmonary Sarcoidosis

Öcal¹,

Bilgiç²,

Tozkoparan³

et al. 2015

Turkiye Klinikleri Arch Lung

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Ö ÖZ ZE ET T A Am ma aç ç: : Sarkoidozun kesin tanısı için histopatolojik incelemede kazeifikasyon göstermeyen epiteloid hücreli granülom yapısının gösterilmesi gereklidir. Bu açıdan; akciğer sarkoidozu kuşkusu olan tüm olgularda bronkoskopi endikasyonu mevcuttur. Seçilecek olan bronkoskopik tekniğin, olgunun klinik ve radyolojik özellikleri ile birlikte değerlendirilmesi önemlidir. Bu çalışmada, olguların radyolojik yaygın-lığı ve ağırlığı, klinik ağırlığı, laboratuvar tetkik sonuçları ile bronkoskopik tetkiklerin tanısal verimlilikleri arasında olası bir ilişkinin ortaya konması hedeflenmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Değerlendirmeye alınan 103 hastanın PA akciğer grafisi, Toraks bilgisayarlı tomografi/yüksek rezolüsyonlu bilgisayarlı tomografileri, spirometri, DLCO, arteriyel kan gazı tahlilleri, biyokimyasal tetkikleri, kötü prognoz kriteri varlığı, bronkoskopik işlemdeki biyopsi tekniği ve sonuçları retrospektif olarak incelenmiştir. B Bu ul lg gu ul la ar r: : Bronkoskopi tanısal verimliliği %91,8 gibi yüksek bir değerde bulunmuştur. Mukoza biyopsisi, transbronşiyal biyopsi ve transbronşiyal iğne aspirasyonunun tek başlarına tanıya katkıları sırasıyla %12,2, %34,4 ve %8,8 olarak bulunmuştur. Transbronşiyal biyopsi tanısal verimliliği Evre 1 hastalarda Evre 2 hastalardaki kadar yüksek olup, tüm evrelerde en yüksek tanısal verimliliğe sahip yöntem olarak izlenmiştir. Radyolojik yaygınlık ile transbronşiyal biyopsi tanısallığı arasında anlamlı bir ilişki bulunmamış-tır. Mukozal lezyonu olan hastalardaki mukoza biyopsisi tanısal verimliliği anlamlı derecede yüksek izlenmiştir (p<0,05). Mukozal lezyon mevcudiyeti ve mukoza biyopsisi tanısallığının, klinik ve total radyolojik ağırlık ile aralarında anlamlı ilişki saptanmamakla birlikte, fissür çevresinde yer alan mikronodüller, mukoza biyopsisi pozitif olan grupta anlamlı derecede yüksek izlenmiştir (p<0,01). S So on nu uç ç: : Her bir tanısal bronkoskopik tetkikin tanıya tek başına katkısının mevcut olduğu göz önünde bulundurularak uygun hastalarda mümkün olduğunca her üç tetkiki de uygulamanın tanısal verimliliği artıracağı söyle-nebilir. Bu konuda daha geniş, çok-merkezli, prospektif çalışmalar ile sonuçlar geliştirilebilir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Biyopsi; bronkoskopi; sarkoidoz A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Diagnosis of sarcoidosis can be made by histopathological confirmation of granulomas without caseification necrosis. Bronchoscopy is indicated in patients with pulmonary sarcoidosis suspicion. In this study, we aimed to identify if there is a relationship between clinical and laboratory findings, radiological extent and weight with diagnostic efficacy of bronchoscopy in pulmonary sarcoidosis. M Ma at te e--r ri ia al l a an nd d M Me et th ho od ds s: : Chest X-ray and thorax computed tomography/high-resolution computed tomography findings, spirometry, DLCO, arterial blood gas, biochemical test results, presence of poor prognosis criteria, bronchoscopic technique res...

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Flexible Transbronchial Needle Aspiration for the Diagnosis of Sarcoidosis

Cited by 72 publications

References 10 publications

Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients

Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients

Diagnostic value of transbronchial needle aspiration cytology in sarcoidosis

The Relationship Between Diagnostic Efficiency of Bronchoscopy with Clinical and Radiological Findings in Pulmonary Sarcoidosis

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