[Transbronchial biopsy in comparison with catheter aspiration in the diagnosis of peripheral pulmonary nodules].
BACKGROUND
Usually, transbronchial biopsy (TBB) is performed in the evaluation of bronchoscopically invisible solitary nodules and peripheral lesions of the lung. Additionally catheter aspiration can be done with the fiberbronchoscope, also under fluoroscopic guidance, to get cytological material. Despite of its simplicity, the catheter aspiration technique is widely unknown.


METHODS
In a prospective study we compared the diagnostic yield of both procedures concerning malignancy. 28 consecutive patients (age 69.4 +/- 8.9 years) underwent both TBB and catheter aspiration.


RESULTS
The tumor size measured 41.4 +/- 14.5 mm. The frequency of TBB was 3.4 +/- 1.8 and of catheter aspiration 2.6 +/- 1.2 per patient. A malignant tumor was diagnosed in 13 cases by TBB and in 20 cases by catheter aspiration. With the combination of both methods, a malignancy was diagnosed in 23 cases. 3 of 5 bronchoscopically not malignant tumors turned out to be bronchial cancer by surgery, the other 2 were benign in a 2 year follow up.


CONCLUSIONS
The diagnostic yield of catheter aspiration is significantly superior to transbronchial biopsy (77 % compared with 50 %, p < 0.05 chi square test). When combining both methods the result is further improved by about 10 %. Composed to of other cytological methods (transbronchial needle aspiration, brush cytology) aspiration by catheter seems at least comparable, but with cost saving advantages.
Franke
K-J
KJ
Klinik Ambrock, Klinik für Pneumologie, Universität Witten-Herdecke, Hagen. klinik-ambrock.pneumo@t-online.de
Nilius
G
G
Rühle
K-H
KH
D001706:Biopsy / Q000379:methods*; D001707:Biopsy, Needle / Q000379:methods*; D001980:Bronchi / Q000473:pathology*; D002404:Catheterization / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results