Transbronchoscopic needle aspiration in the diagnosis and staging of lung cancer

We examined the safety and yield of transbronchial needle aspiration (TBNA) in 28 patients who were subsequently proven to have lung cancer. TBNA in 48 sites produced no complications. TBNA was positive for carcinoma in the two patients whose tracheal carinae appeared abnormal on computerized tomography. When the carinae were normal, only one of 13 aspirations was positive for cancer. None of eight paratracheal aspirations was positive. Aspiration of visibly abnormal bronchial bifurcations revealed carcinoma in four of 15 cases. We conclude that TBNA is a safe procedure for the diagnosis and staging of lung cancer, and that the likelihood of positive results is increased by the presence of radiologic and endoscopic abnormalities.