Transbronchial Needle Aspiration for Cytology and Histology Specimens

Wang, Ko Pen; Mehta, Atul C.; Turner, J. Francis

doi:10.1002/9781444346428.ch11

Cited by 7 publications

(10 citation statements)

References 105 publications

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“…However, there is great variability in the results obtained depending on endoscopist experience [3], adenopathy characteristics and their location [4-6], type of needle used [1,2,7], etiology of mediastinal adenopathies [8], possibility of an immediate evaluation by a cytopathologist [9], or use of accessory techniques such as bronchoscopic ultrasound for adenopathy detection [10]. Further, factors that can influence the evaluation of the outcome are prevalence of underlying pathologies [11] and interpretation of the results from other published studies [12,13].…”

Section: Introductionmentioning

confidence: 99%

Validity and reliability of transbronchial needle aspiration for diagnosing mediastinal adenopathies

et al. 2010

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BackgroundThe aim is to assess the validity and reliability of transbronchial needle aspiration (TBNA) of mediastinal and hilar adenopathies and to evaluate factors predictive of TBNA outcome.MethodsWe performed an analysis of prospectively collected data of patients (n = 580) who underwent TBNA (n = 685) from January 1998 to December 2007 in our center. Validity and reliability were evaluated for the overall sample and according to specific pathology. Factors predicting the successful acquisition of diagnostic samples were analyzed by multivariate analysis.ResultsOverall sensitivity, specificity, accuracy, and positive and negative predictive (NPV) values for TBNA were 68%, 100%, 68.8%, 100%, and 10%, respectively. The most sensitive and accurate TBNAs were obtained for patients with small cell lung carcinoma and the worst results were for patients with lymphomas. NPV were similar for all pathologies. The most predictive factors of outcome were adenopathy size and the presence of indirect signs at the puncture site.ConclusionThe sensitivity and accuracy of TBNA are high in small cell lung cancer, followed by other types of carcinoma, sarcoidosis, and tuberculosis, and low for lymphoproliferative diseases. The NPV of TBNA for all individual pathologies is low. The size of the adenopathy and the presence of indirect signs at the puncture site predict the achievement of diagnostic samples.

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Section: Introductionmentioning

confidence: 99%

Validity and reliability of transbronchial needle aspiration for diagnosing mediastinal adenopathies

et al. 2010

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“…TBNA is a widely available technique that can be used to make a specific diagnosis by sampling mediastinal adenopathy and other tissues in close proximity to airways. It has been proved useful in the diagnosis of granulomatous diseases, infections, and malignancies that affect mediastinal lymph nodes (11). Therefore, surgical biopsy can be avoided with use of TBNA (11,12).…”

Section: Discussionmentioning

confidence: 99%

“…It has been proved useful in the diagnosis of granulomatous diseases, infections, and malignancies that affect mediastinal lymph nodes (11). Therefore, surgical biopsy can be avoided with use of TBNA (11,12). To our knowledge, only 3 cases of amyloidosis diagnosed by TBNA with (13,14) or without (15) ultrasound guidance for mediastinal lymph nodes have been reported.…”

Section: Discussionmentioning

confidence: 99%

Waldenström's Macroglobulinemia Accompanying Systemic Amyloidosis: The Usefulness of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration for Detecting Amyloid Deposits

Ishiguro¹,

Takayanagi²,

Katoh

et al. 2014

Intern. Med.

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A 75-year-old man with a history of dyspnea lasting for three years presented to our hospital. Chest computed tomography showed bilateral pulmonary nodules, some of which were calcified, in addition to mediastinal/hilar lymphadenopathy and bilateral pleural effusions. Endobronchial ultrasound-guided (EBUS) transbronchial needle aspiration (TBNA) of the subcarinal lymph nodes showed amorphous acellular material compatible with λ-light chain amyloid deposits. Sternal bone marrow aspiration demonstrated increased small lymphocytes admixed with plasma cells and plasmacytoid lymphocytes. Serum immunoglobulin values were decreased with the exception of immunoglobulin M monoclonal peak. We subsequently diagnosed the patient as having Waldenström's macroglobulinemia accompanying AL-type amyloidosis. In this case, EBUS-TBNA was useful for detecting AL-type amyloidosis.

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“…The insertion point was determined after a careful analysis of thoracic CT and following previous recommendations by other authors [5,6]. TBNA was carried out at the most accessible and largest adenopathy when there were several lymph node enlargements.…”

Section: Tbna Proceduresmentioning

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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Transbronchial Needle Aspiration for Cytology and Histology Specimens

Cited by 7 publications

References 105 publications

Validity and reliability of transbronchial needle aspiration for diagnosing mediastinal adenopathies

Validity and reliability of transbronchial needle aspiration for diagnosing mediastinal adenopathies

Waldenström's Macroglobulinemia Accompanying Systemic Amyloidosis: The Usefulness of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration for Detecting Amyloid Deposits

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

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