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Clinical InvestigationsLUNG CANCERUtility of Transbronchial Needle Aspiration in the Diagnosis of Endobronchial Lesions
Section snippets
Materials and Methods
Patients found to have EML or SPD during routine fiberoptic bronchoscopy were entered in the study. Patients with preexisting known malignancy were excluded. Submucosal disease was defined as erythema, vascular flares, enhanced rugal pattern, thickening or loss of mucosal markings, and bronchial narrowing. Peribronchial disease was defined as luminal narrowing secondary to extrinsic compression.
All patients had bronchial washings (BW), brush biopsy (BB), EBB, and TBNA. The procedural sequence
Results
During a 15-month period, 58 patients were enrolled in the study (Fig 1). Three patients were excluded–two because of benign lesions (one with granulation tissue and one with benign sinus histiocytosis on mediastinoscopy), and one patient refused further investigations.
Of the 55 eligible patients, 32 (58%) had EML and 23 (42%) had SPD. Malignancy was confirmed by bronchoscopy in 53 patients–1 patient had metastatic malignant melanoma and 52 patients had primary lung cancer. The two patients
Discussion
Only a small number of investigators have addressed the issue of TBNA in EML or SPD.67891011 The yield from EBB for EML has been reported to be between 67% and 100% in different series.34578910 The yield could be decreased if there is surface necrosis of the tumor, sampling error, or inadequate tissue, or in the presence of crush artifacts. Similarly, the yield from BB and BW has been demonstrated to be between 55% and 93%,37891012 and 0% and 63%,791012respectively. Furthermore, reported yield
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Cited by (108)
Bronchoscopic sampling techniques in the era of technological bronchoscopy
2022, PulmonologyCitation Excerpt :EBB is usually employed for suspected bronchogenic cancer with a sensitivity of 74%39: ...3 biopsies are recommended for diagnosis, although at least 6 biopsies can provide sufficient tissue for immunohistochemical and molecular testing.39,67 Several studies36,68,69 demonstrated that the combination of EBB and endobronchial needle aspiration can achieve the best diagnostic performance. EBB, when combined with transbronchial biopsy, can increase the sensitivity of bronchoscopy by 10...20% in the diagnosis of sarcoidosis: sampling should be performed where the mucosa is abnormal and in the first and second carina if the mucosa seems normal (4...6 endobronchial biopsies); 30% with normal mucosa may have positive EBB.70...72
Interventional Bronchoscopy
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2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth Edition
Presented in abstract form at the annual session of the American Thoracic Society, Chicago, IL, April 28, 1998.