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Clinical InvestigationsLUNG BIOPSYDiagnostic Value of Transbronchial Needle Aspiration by Wang 22-Gauge Cytology Needle in Intrathoracic Lymphadenopathy
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Materials and Methods
In this prospective study from August 1998 to June 2002, TBNA procedures were performed in 60 patients (36 women and 24 men; mean age, 39 ± 16 years [± SD]) who were consecutively admitted or referred to our hospital. All patients undergoing bronchoscopy with TBNA for the diagnosis of intrathoracic lymphadenopathy without any definitive pulmonary lesions revealed by chest CT were included in our study. The final diagnoses of the patients consisted of tuberculosis (n = 21; 15 women and 6 men;
Results
Adequate lymph node samples were obtained in 59 of 60 patients (98%). We were able to make a diagnosis in 45 of 59 patients (76%) whose adequate lymph node samples were obtained by TBNA. TBNA was the only diagnostic tool in 30 of 60 patients (50%). Results of TBNA and additional diagnostic methods in study patients are given in Table 1. TBNA was targeted to different endobronchial sites (mean, 2.3 ± 0.8; minimum 1, maximum 4) according to pathologic lymph nodes identified by CT. TBNA was
Discussion
TBNA is a safe and effective way to assess mediastinal lymphatic involvement in the diagnosis and staging of lung cancer.12 There is limited experience in the diagnosis of mycobacterial intrathoracic lymph nodes with cytologic specimens obtained by TBNA in HIV-negative patients.38910 However, diagnosis is an important problem not only in HIV-positive patients with tuberculosis of intrathoracic lymph nodes but also HIV-negative patients.8910 In our study, diagnoses made by TBNA were tuberculosis
Conclusion
We conclude that TBNA with a Wang 22-gauge cytology needle is an effective and safe way to obtain cytologic specimens from intrathoracic lymph nodes and can rapidly provide a diagnosis, both in malignant and benign mediastinal disease. Hopefully, this technique will reduce further need for more invasive surgical procedures.
ACKNOWLEDGMENT
The authors thank Nur Urer, MD, for help with cytopathologic examinations.
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Respiration
(2002)