Transbronchial needle aspiration in clinical practice. A five-year experience

Area of Science:

• Pulmonology
• Oncology
• Diagnostic Imaging

Background:

• Bronchoscopy is a common procedure for diagnosing lung conditions.
• Accurate staging of lung cancer is crucial for effective treatment planning.
• Assessing mediastinal lymph node involvement is a key component of lung cancer staging.

Purpose of the Study:

• To review the clinical utility of transbronchial needle aspiration (TBNA) over a five-year period.
• To evaluate the safety and efficacy of TBNA in diagnosing malignant neoplasms.
• To assess the role of TBNA in the initial bronchoscopic examination for lung cancer staging.

Main Methods:

• A retrospective review of 1,630 bronchoscopic procedures was conducted.
• TBNA was performed on 633 patients (39%) as part of their initial examination.
• Cytologic results from TBNA were compared with histologic material where available.

Main Results:

• Mediastinal nodes were sampled in 86% of TBNA procedures, with 23% positive for malignancy.
• TBNA of abnormal tracheobronchial areas yielded malignant cells in 25% of aspirates.
• TBNA of N2 nodes showed a 59% positivity rate for small-cell lung cancer and 28% for non-small-cell lung cancer.
• An excellent correlation was observed between TBNA cytology and histology.
• TBNA provided the sole diagnosis of cancer in 4% of cases, with no significant complications.
• False-positive results were noted in two patients.

Conclusions:

• TBNA is a safe and effective method for evaluating mediastinal lymphatic involvement in lung cancer staging.
• TBNA can be safely incorporated into the initial bronchoscopic examination for suspected thoracic malignancies.
• The procedure demonstrates high diagnostic yield and correlation with histology, supporting its role in clinical practice.