Transbronchial needle aspiration in the diagnosis of respiratory diseases

Thirty-three patients were subjected to transbronchial needle aspiration during the routine diagnostic bronchoscopy. Of the 17 patients with submucosal diseases, Transbronchial needle aspiration (TBNA) had a yield of 88.2% as against 81.2% for bronchial biopsies, 54.5% for bronchial brush smears and 41.1% for bronchial aspirates. TBNA also had a good yield in endobronchially visible growths. Nine patients had mediastinal or hilar lymph nodes as evident in contrast enhanced CT scans. TBNA was attempted from eight lymph node sites in six patients with bronchogenic carcinoma and was positive for malignant cells from four of these sites, while normal lymphoid cells were obtained from the other four sites. TBNA could also diagnose the disease from the left hilar lymph node in one patient with sarcoidosis, an extra tracheal bronchogenic carcinoma in another patient and an extra bronchial metastasis in yet another patient where conventional bronchoscopic techniques failed. TBNA was found to be a safe, cost effective and valuable diagnostic tool in the diagnosis of pulmonary diseases.