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Cost effectiveness of transbronchial needle aspiration: RESULTS (1)

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.

Positive aspirates: TBNA was positive and yielded a diagnosis in 42 patients (44%) and was negative in 54 patients. Of the 42 patients with a positive aspirate, 40 had malignant cytology results and two had cells consistent with benign disease (sarcoidosis). The histopathological diagnoses established in the patients with malignant disease are listed in Table 2.

TBNA was the only positive specimen in 15 of the 56 patients with bronchogenic carcinoma (27%). Seven of these patients had small cell carcinoma, seven had adenocarcinoma and one had squamous cell carcinoma. The remaining patients with bronchogenic carcinoma were diagnosed by bronchoscopic endobronchial sampling, CT guided transtho-racic needle aspiration and thoracotomy.

Table 1. Diagnoses of the study population undergoing transbronchial needle aspiration (n=96)

Diagnosis N
Bronchogenic carcinoma 56
Lymphoma 2
Mediastinal/hilar adenopathy in the setting of nonlung cancer 7
Sarcoidosis 9
Mycobacterium tuberculosis 2
Other benign conditions 17
Total 95*
*One patient lost to follow-up and three patients had two separate procedures

Table 2. Histopathological diagnoses for malignant transbronchial needle aspiration

Diagnosis Patients N (%)
Adenocarcinoma 20
Squamous cell 6
Large cell anaplastic 1
Small cell 13
Total 40
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Category: Cost effectiveness

Tags: Cost effectiveness, Mediastinal staging, TBNA, Transbronchial needle aspiration

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