Jain et al performed a cost analysis on a hypothetical cohort of 1000 patients with mediastinal lymphadenopa-thy. The patients underwent either initial bronchoscopy with TBNA, followed by mediastinoscopy if the TBNA was negative (strategy A) or mediastinoscopy without TBNA (strategy B). They calculated a cost savings of US$1.67 million/1000 patients by using strategy A.
In 1998, Katis et al reported a prospective study involving 76 patients with chest radiographs suggestive of lung cancer and with evidence of mediastinal adenopathy on CT. Cytological examination of TBNA was positive for malignancy in 72% of patients. In the present study, 40 of 56 patients with bronchogenic carcinoma had a positive TBNA, a…
TBNA is an established procedure for the diagnosis and staging of lung cancer. The procedure is safe with few complications documented in the literature . This is comparable with a complication rate for cervical mediastinoscopy of 2.5% . The literature reports varied diagnostic yields of TBNA in patients with bronchogenic carcinoma.
The positive TBNA result altered further management in 22 of the 40 patients with malignant disease and one of two patients with benign disease. In the remaining 18 patients with malignancy, management was not altered because the tumours were deemed surgically unresectable for reasons including tumour cell type (small cell carcinoma), tumour stage or concurrent…
Ninety-nine patient records were reviewed. Table 1 depicts the final diagnoses of the study population. Fifty-six patients had bronchogenic carcinoma, while the remainder had a variety of diagnoses including lymphoma, nonlung malignancy, sarcoidosis, pulmonary fibrosis, thyroid mass, bronchiolitis obliterans organizing pneumonia and infection.
Specimens interpreted as suspicious for carcinoma were considered negative for purposes of the study. Benign disease was more difficult to diagnose with TBNA cytology specimens, but aggregates of epithelioid cells and histiocytes consistent with granulomata were considered positive for sarcoidosis. The false positive and false negative rates of TBNA were not studied; however, no false…
The records of all patients who underwent TBNA at the University of Alberta Hospitals, Edmonton, Alberta between February 1996 and February 1998 were reviewed. A total of 96 patients with computed tomography (CT) criteria for significant mediastinal adenopathy (defined as any node greater than 1 cm in diameter in the short axis), hilar adenopathy or…
Transbronchial needle aspiration (TBNA) of hilar and mediastinal lymph nodes through the flexible bronchoscope has been available for the past two decades and has been shown to be an effective technique in the diagnosis and staging of lung cancer .
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