Transbronchial needle aspiration in the diagnosis of bronchogenic carcinoma

Transbronchial needle aspiration (TBNA) via a fiberoptic bronchoscope has been used for diagnosis of lung cancer by Wang since 1981. The technique uses a fiberoptic bronchoscope with a flexible needle that can penetrate the wall of the trachea and major bronchi. It is still underutilized and markedly depends on the physician's skill. We present our experience of TBNA for diagnosis of bronchogenic carcinoma. TBNA was performed on 47 consecutive patients with suspected lung cancer at the time of diagnosis bronchoscopy. Thirty six patients were diagnosed with bronchogenic carcinoma. TBNA demonstrated bronchogenic carcinoma in 61.1 per cent of the cases (22 of 36) and TBNA alone confirmed a malignant diagnosis in 33.3 per cent (12 of 36). The overall diagnostic yield of bronchoscope utilizing the conventional techniques of bronchial washing, brushings and biopsy was 50 per cent. With the addition of TBNA, bronchoscopy was diagnostic in 83.3 per cent of the patients. There were no serious complications. We concluded that TBNA is a safe technique that can significantly increase the diagnostic yield of conventional fiberoptic bronchoscopy in the diagnosis of bronchogenic carcinoma.