title: Flexible Bronchoscopy in the Evaluation of Mediastinal and Hilar Lymphadenopathy.
abstract: BACKGROUND
  The diagnosis in cases of mediastinal and/or hilar lymphadenopathy with no lung parenchymal involvement is often difficult. We undertook this study to assess the diagnostic value of flexible bronchoscopy (FOB) especially transbronchial needle aspiration (TBNA) and transbronchial lung biopsy (TBLB) in these patients.
  
  
  METHODS
  Forty eight patients with hilar and/or mediastinal lymphadenopathy without any parenchymal lung lesions, managed between 2000 to 2004 at a tertiary care centre who underwent FOB were evaluated retrospectively.
  
  
  RESULTS
  Out of 48 patients, FOB showed widening of carina in six, widening of secondary carina in four, bulge in airways because of extrinsic compression in seven and endobronchial nodule in two patients. It was normal in rest 29 patients. TBNA was done in all patients and TBLB in 13 patients where clinico-radiologic findings were consistent with stage 1 sarcoidosis. FOB established diagnosis in 18 patients (caseating granuloma in eight, noncaseating granuloma in nine, and AFB culture positive in one). It was inconclusive in other patients. One patient developed pneumothorax requiring intercostal tube drainage.
  
  
  CONCLUSIONS
  FOB especially TBNA has an important role in the diagnosis of hilar and mediastinal lymphadenopathy and should be considered before other invasive procedures.
authors.affiliation: Senior Advisor (Medicine & Respiratory Medicine) Military Hospital (CTC) Pune - 40.
authors.forename: S P
authors.initials: SP
authors.lastname: Rai
authors.affiliation: Classified Specialist (Medicine & Respiratory Medicine), Base Hospital, Delhi Cantt - 10.
authors.forename: D
authors.initials: D
authors.lastname: Bhattacharyya
authors.affiliation: ADMS, HQ 23 Inf Div, C/o 99APO.
authors.forename: R K
authors.initials: RK
authors.lastname: Choudhary
keywords: Flexible bronchoscopy; Hilar lymphadenopathy; Mediastinal lymphadenopathy; Transbronchial biopsy; Transbronchial needle aspiration