title: Diagnostic value of transbronchial needle aspiration by Wang 22-gauge cytology needle in intrathoracic lymphadenopathy.
abstract: OBJECTIVE
  The aim of this study was to investigate the diagnostic value of transbronchial needle aspiration (TBNA) performed with a Wang 22-gauge cytology needle in patients with mediastinal and/or hilar adenopathy.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Tertiary care training hospital.
  
  
  METHODS
  TBNA procedures were performed using a flexible bronchoscope and a 22-gauge Wang needle in 60 consecutive patients (36 women and 24 men; mean age, 39 +/- 16 years [+/- SD]) who had mediastinal or hilar adenopathy identified on CT of the chest.
  
  
  RESULTS
  Adequate lymph node sampling was obtained from 59 of 60 patients (98%). We were able to make a diagnosis in 45 of 60 patients (75%). TBNA was the only tool of diagnosis in 30 of the 60 patients (50%). Diagnoses included tuberculosis (n = 21), sarcoidosis (n = 21), carcinoma (n = 15), and lymphoma (n = 3). Adequate material was obtained from 20 of 21 patients with tuberculosis. The diagnosis made by TBNA was tuberculosis in 13 of 20 cases (65%). In 12 patients, diagnosis of tuberculosis was made cytologically; for the remaining 1 patient, mycobacterial culture was used. TBNA was the only diagnostic tool utilized in 8 of 20 patients with tuberculosis (40%). Diagnostic material was obtained from 16 of 21 patients with sarcoidosis (76%). In sarcoidosis, TBNA provided the only diagnostic specimen in 13 of 21 patients (62%). In all 15 patients with carcinoma (100%), diagnostic materials were obtained. Adequate but nondiagnostic samples were obtained from two patients with lymphoma, and one patient had lymphoma successfully diagnosed with TBNA. No complications were seen except minimal bleeding.
  
  
  CONCLUSIONS
  TBNA performed with a Wang 22-gauge cytology needle is an effective and safe way of obtaining cytologic specimens from intrathoracic lymph nodes and can rapidly provide diagnosis, both in malignant and benign mediastinal diseases. Hopefully, this technique will reduce further need for more invasive surgical procedures.
authors.affiliation: Department of Pulmonology, Yedikule Chest Diseases and Chest Surgery Training Hospital, Istanbul, Turkey.
authors.forename: Erdogan
authors.initials: E
authors.lastname: Cetinkaya
authors.forename: Pinar
authors.initials: P
authors.lastname: Yildiz
authors.forename: Sedat
authors.initials: S
authors.lastname: Altin
authors.forename: Veysel
authors.initials: V
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D001707:Biopsy, Needle / Q000295:instrumentation* / Q000379:methods; D001980:Bronchi / Q000473:pathology; D001999:Bronchoscopy; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D018570:Risk Assessment; D017565:Sarcoidosis, Pulmonary / Q000473:pathology; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000473:pathology