Role of Transbronchial Needle Core Biopsy in the Diagnosis of Mediastinal Diseases: Experience With an Innovative Endoscopic Technique Using a Rigid Tru-Cut Needle.
BACKGROUND
Enlarged lymph nodes or mediastinal masses diagnosed by computed tomographic scan before the advent of bronchoscopic procedures (TBNA or EBUS) were usually investigated using a thoracic surgical approach. In this paper, we report the experience with the use of a modified rigid tru-cut needle in the bioptical approach to mediastinal masses; to determine whether it could be considered a valid alternative to surgery, we investigated the diagnostic accuracy of this new endoscopic technique.


METHODS
A total of 156 selected patients with radiographic evidence of lymphadenopathy or mediastinal masses (subcarinal and paratracheal with a short-axis diameter >3 cm) were studied in our center by rigid bronchoscopy using a 18-G tru-cut needle to obtain a core biopsy of the lesion.


RESULTS
In 140 of 156 cases (89.7%), a histologically correct diagnosis was reached without perioperative or postoperative complications. A total of 114 (81.4%) malignant and 26 (18.6%) benign lesions were diagnosed avoiding further invasive surgical approach.


CONCLUSIONS
Our results confirm that, in selected cases, transbronchial rigid core biopsy could be considered a safe and valid alternative technique to more invasive surgical approach in the diagnosis of mediastinal diseases.
Center of Thoracic Endoscopy, San Camillo-Forlanini Hospital, Rome.
Giovanni
G
Galluccio
Operative Unit of General and Thoracic Surgery, Policlinico Paolo Giaccone, Palermo, Italy.
Manuela
M
Palazzolo
Center of Thoracic Endoscopy, San Camillo-Forlanini Hospital, Rome.
Paolo
P
Battistoni
Center of Thoracic Endoscopy, San Camillo-Forlanini Hospital, Rome.
Raffaele
R
Dello Iacono
Center of Thoracic Endoscopy, San Camillo-Forlanini Hospital, Rome.
Sandro
S
Batzella
Center of Thoracic Endoscopy, San Camillo-Forlanini Hospital, Rome.
Umberto
U
Caterino
Center of Thoracic Endoscopy, San Camillo-Forlanini Hospital, Rome.
Gabriele
G
Lucantoni
D062005:Biopsy, Large-Core Needle / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000473:pathology*; D008481:Mediastinoscopy / Q000295:instrumentation* / Q000379:methods*; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D015203:Reproducibility of Results