[Transbronchial needle aspiration as a diagnostic method in lung cancer and non-malignant mediastinal adenopathy].
BACKGROUND
The aim of the study was to assess the diagnostic yield of transbronchial needle aspiration (TBNA) in mediastinal or hilar adenopathy in: lung cancer, staging of NSCLC, sarcoidosis and other non-malignant diseases.


METHODS
Transbronchial needle aspiration was performed in 347 consecutive patients - 402 biopsies in groups of lymph nodes: subcarinal (7) - 179, all paratracheal (2R, 2L, 4R, 4L) - 168 and hilar (10R, 10L) - 55, with no real-time imaging guidance, preceded by computed tomography (CT), using 22-gauge needles. All negative results in NSCLC patients were verified by transcervical extended bilateral mediastinal lymphadenectomy (TEMLA) and the remaining patients underwent mediastinoscopy or thoracotomy.


RESULTS
TBNA technique was diagnostic in 67.1% of lung cancer patients and in 59.0% of patients with sarcoidosis. In the group of all lung cancer patients specificity was 100%, sensitivity 88.5%, accuracy 91.8% and negative predictive value 77.9% and in diagnosing of lymph nodes involvement in NSCLC was respectively 100%, 86.6%, 90.7% and 76.6%. The high diagnostic yield was comparable for all mediastinal groups. In 80% of NSCLC patients with false negative results of TBNA there was observed partial involvement of metastatic lymph nodes, confirmed by TEMLA.


CONCLUSIONS
The diagnostic value of TBNA is very high in diagnostics of lung cancer, NSCLC staging and sarcoidosis but much lower in lymphomas, tuberculosis and other non-malignant diseases.
Szlubowski
Artur
A
Oddział Pulmonologii i Pracownia Bronchoskopii Samodzielnego Publicznego Specjalistycznego Szpitala Chorób Płuc w Zakopanem Ordynator Oddziału. artondo@mp.pl
Kuzdzał
Jarosław
J
Soja
Jerzy
J
Łaczyńska
Ewa
E
Hauer
Jolanta
J
Kopiński
Piotr
P
Tomaszewska
Romana
R
Zieliński
Marcin
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008197:Lymph Node Excision; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000473:pathology; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000473:pathology*; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011237:Predictive Value of Tests; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000175:diagnosis / Q000473:pathology