Bronchial submucosal needle aspiration performed through the fiberoptic bronchoscope

Retrospective review of 251 bronchial submucosal needle aspirations obtained from 171 patients with unsuspected pulmonary malignancy showed that adequate cytologic material was obtained in 87.6% of the aspirations. Eighty-one patients were found to have primary bronchogenic carcinomas (with a visible endobronchial tumor in 39), and 21 had secondary pulmonary metastases. The overall diagnostic accuracy of bronchial submucosal aspiration was 81%, with only four definite false-negative and no false-positive results. The diagnostic accuracy was 82% for bronchial brushing, 71% for forceps biopsy, 67% for postbronchoscopy sputum cytology and 46% for bronchial washing. The major advantage of the submucosal aspiration technique was in evaluating mural mucosal lesions, especially those covered with intact mucosa, that were not readily accessible to forceps biopsy or successful brush sampling. Negative results from a needle aspiration must be interpreted with caution because of the small area a single sample represents. Multiple sequential submucosal aspirations may be helpful in assessing the resectability of bronchial neoplasms. No complications have been encountered with this technique.