Needle aspiration biopsy as an adjunct to mediastinoscopy

Conventional mediastinoscopy has a small but definite morbidity and mortality. Our continuing study was done to determine whether needle aspiration during mediastinoscopy is a safe and reliable procedure. In 14 consecutive patients having mediastinoscopy, needle aspiration biopsy was also done. There was a 100% correlation between diagnosis made by needle cytology and the final diagnosis, with neither false-positive nor false-negative results. This correlation was only 75% in the forceps biopsy group. In 90% of the cases, the cytopathologist correctly identified the final cell type. There were no complications, even in cases of superior vena caval (SVC) obstructions. The distinct advantages of the technique include high specificity, better tissue sampling, immediate availability of results, reduced morbidity, expanded indications in SVC syndromes, and higher yield than conventional punch biopsies.