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Updated: Jul 10, 2026

Systematic Endobronchial Ultrasound - The Six Landmarks Approach
Published on: August 11, 2023
[Transbronchial needle aspiration of hilar and mediastinal lymph nodes]
Deborah Lannes1, Andréia Salarini Monteiro, Edson Toscano
1Thoracic Oncology Group - Hospital do Câncer - HC I - INCA/MS.
Background:
Besides clarifying the etiology of unidentified lymphadenomegaly, puncturing hilar and mediastinal lymph nodes by a flexible bronchoscopic needle is an aid in diagnosing and staging broncho- genic cancer or other metastatic cancers.
Objective:
Our study had the principal objective to evaluate the positivity of transbronchial needle aspiration (TBNA).
Method:
We evaluated retrospectively the effectiveness of all TBNA done in 74 consecutive patients. Forty-nine patients were male and the median age was 59. We used Wang-needles, 21-gauge (Bard, USA), and the same technique described for different authors. Of the 74 patients evaluated, 11(15%) showed mediastinal mass and 65 (85%) hilar mass. We observed 76 endoscopic abnormalities.
Results:
According to the classification of the specimens, we had 32/74 (43%) unsatisfactory specimens, 34/74 (46%) satisfactory and diagnostic specimens, and 8/74(11%) satisfactory and non-diagnostic specimens. Thirty four (46%) of the examinations were found to be positive out of the total amount of specimens. Of the positive results, 30/34 specimens (88%) contained malignant disease. Small-cell carcinoma was the most frequent finding, with 10/34 cases (29%); squamous cell carcinoma 7/34 (21%); adenocarcinoma 7/34 (21%), non- -small cell carcinoma 6/34 (17%); sarcoidosis 2/34 (6%) and tuberculosis 2/34 (6%).
Conclusion:
Our study indicated that this method is safe, easy to per- form, with a minimum of complications and useful for the diagnosis and staging of pulmonary neoplasms.
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