Transbronchial fine needle aspiration.

Abstract

In a pilot study, 21 patients underwent transbronchial fine needle aspiration (TBFNA) using a 45 cm-22 gauge needle guided by means of a semi-rigid metal sleeve, which was introduced through a standard rigid bronchoscope. A total of 33 aspirations were performed from main carina (15), paratracheal (five), and lobar carinal (13) The accepted methods of obtaining biopsies from mediastinal and para-mediastinal tissues are based on mediastinoscopy,1 2 anterior mediastinotomy,3 thoracotomy and median sternotomy. All these methods involve surgical intervention with its associated risks and expense. In many cases the aim is basically to establish an accurate pathological diagnosis. A method which can provide a pathological diagnosis with lesser invasion is advantageous.Lately microscope diagnosis of pulmonary and mediastinal malignancies has been obtained by means of transthoracic fine needle aspiration.4 However, this method has been used only in those cases in which the lesion was radiologically demonstrated, and it does not provide the surgeon with the information on mediastinal and hilar lymph node pathology which he requires for the assessment of operability.Based on our diagnostic experience in pulmonary cytology and technical experience in bronchoscopy and transthoracic FNA, we have combined both in a procedure directed towards obtaining cellular material by means of fine needle aspiration through the bronchial or tracheal wall during diagnostic bronchoscopy.Wang et a15 reported a series of five patients in whom paratracheal masses were aspirated transtracheally using a rigid bronchoscope and an oesoAddress for reprint requests:

Cytopathologic Analysis of Paratracheal Masses

“…Early reports actively discouraged the use of incisional biopsy and FNA due to potential complications of hemorrhage, infection and tumor seeding. 1,3,9,10 More recent reports describing FNA of head and neck lesions have shown these previous beliefs to be unfounded. 11,12 With this paradigm shift and advances in endoscopic ultrasonography-FNA 7,13,14 and percutaneous CTguided biopsy, 15 sampling of the PTS has become a common first step in diagnosis.…”

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].…”