title: Transbronchial needle aspiration: a tool for a community bronchoscopist.
abstract: BACKGROUND
  Conventional transbronchial needle aspiration (C-TBNA) has been proven to be a safe, minimally invasive, and cost-effective technique in establishing the diagnosis of mediastinal pathologies. We studied the success of C-TBNA in our community practice, in patients with mediastinal lymphadenopathies.
  
  
  METHODS
  The technique of C-TBNA was learned solely from the literature, videos, and by practicing on inanimate models during "hands-on" courses. Conventional TBNA with 21- and/or 19-gauge Smooth Shot Needles was performed on consecutive patients with undiagnosed mediastinal lymphadenopathy.
  
  
  RESULTS
  Fifty-four patients (38 men), mean age 56.9±11.8 years, underwent C-TBNA. Thirty-three patients had nodes >20 mm. The final diagnoses were malignancy, 29; sarcoidosis, 9; reactive lymph nodes, 15; and tuberculosis, 1. The final diagnosis was established by C-TBNA in 27. The exclusive diagnostic yield of TBNA was 42.5% (n: 23). Nodal size had an impact on outcome (P=0.002), whereas location did not (P=0.82). C-TBNA was positive in 22/34 when malignancy was suspected (yield 64.7%) and positive in 5/20 when benign diagnoses were also included in the differential (yield 25%) (P=0.005). The sensitivity, specificity, positive predicted value, negative predicted value, and diagnostic accuracy were 79.4%, 100%, 100%, 73%, and 81.5%, respectively.
  
  
  CONCLUSIONS
  C-TBNA can be successfully learned without formal training and can be easily applied in the community practice.
authors.affiliation: Pulmonary Diseases Department, Başkent University School of Medicine, Ankara, Turkey. elifkupeli@yahoo.com
authors.forename: Elif
authors.initials: E
authors.lastname: Küpeli
authors.forename: Ruhsel
authors.initials: R
authors.lastname: Cörüt
authors.forename: Leyla
authors.initials: L
authors.lastname: Memiş
authors.forename: Füsun Oner
authors.initials: FO
authors.lastname: Eyüboğlu
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods / Q000592:standards; D001999:Bronchoscopy / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary; D008206:Lymphatic Diseases / Q000209:etiology / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology / Q000473:pathology*; D008875:Middle Aged; D017565:Sarcoidosis, Pulmonary / Q000473:pathology; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000473:pathology