Transbronchial needle aspiration in the staging of bronchogenic carcinoma

To evaluate the usefulness of transbronchial needle aspiration biopsy (TBNA) for the diagnosis of mediastinal involvement, we have prospectively examined 316 patients with morphologically verified bronchogenic carcinoma. The percentage of positive aspirations (149 of 316) from the three basic lymph node groups in the mediastinum was not significantly different. Tumor cells were aspirated from the mediastinum in 75 of 112 patients with radiologically positive findings and in patients with 74 of 204 radiologically negative findings. Mediastinal involvement was verified even in 61 of 196 patients with a normal endoscopic picture. Metastases were proved in 14 of 39 patients with peripheral versus 135 of 277 patients with central carcinoma. Tumor cells were aspirated in 47 of 76 patients with undifferentiated small cell carcinoma, 92 of 227 patients with squamous cell carcinoma, and 10 of 13 patients with adenocarcinoma. Our results suggest that TBNA being a highly diagnostic and less invasive method, will prove its clinical importance.