Chest
Flexible Transbronchial Needle Aspiration for Staging of Bronchogenic Carcinoma
Section snippets
Patient Population
Patients with known or suspected bronchogenic carcinoma who were referred to the bronchoscopy service of the Johns Hopkins Hospital between Nov 1, 1981, and Nov 17, 1982, were included in this study if a staging procedure was indicated at the time of bronchoscopy. In 28 patients with undiagnosed pulmonary lesions, bronchoscopy was performed primarily for diagnostic purposes. In the remaining 11 patients, bronchoscopy was performed solely for staging. Patients with known small cell carcinoma,
Results
Thirty-nine patients met criteria for inclusion in the study. Bronchoscopy and TBNA were repeated in one patient with an initial equivocal TBNA specimen for a total of 40 procedures. The histologic classifications and the primary anatomic locations of their neoplasms are summarized in Table 1. The diagnosis of carcinoid tumor was not made until thoracotomy in two patients, who are included in this series because they underwent preoperative staging with a presumptive diagnosis of bronchogenic
Discussion
These data indicate that staging of bronchogenic carcinoma to define mediastinal nodal involvement (N status), as well as the extent of endobronchial disease (T status), can now be combined effectively with diagnostic fiberoptic bronchoscopy (Fig 1). Furthermore, this objective can be achieved both safely and accurately. The diagnostic efficacy of TBNA compared favorably with that of roentgenographic staging methods, with the added advantages provided by cytopathologic information. In many of
ACKNOWLEDGMENT
We writers thank Betty Giacomazza and Lorena Clary for secretarial assistance and Pam Mason and Jennifer Grago for providing the illustrations.
References (32)
- et al.
Factors influencing survival after resection for bronchial carcinoma
J Thorac Cardiovasc Surg
(1972) - et al.
Prognostic factors in malignant tumors in the lung: an analysis of 582 cases
Ann Thorac Surg
(1968) - et al.
Transcarinal bronchoscopic needle biopsy
Ann Thorac Surg
(1965) - et al.
An appraisal of newer diagnostic methods for intrathoracic lesions
Chest
(1968) - et al.
Transbronchial needle aspiration for diagnosis of lung cancer
Chest
(1981) Introduction to clinical decision making
Sem Nucl Med
(1978)- et al.
Selectivity in the surgical treatment of bronchogenic carcinoma
J Thorac Cardiovasc Surg
(1971) An evaluation of mediastinoscopy in the management of presumably operable bronchial carcinoma
J Thorac Cardiovasc Surg
(1968)- et al.
Bronchogenic carcinoma
Acta Chir Scand
(1965) - et al.
Choice of operation in the treatment of bronchogenic carcinoma: a review of 813 cases of which 209 were treated by resection
Chest
(1963)
Bronchoscopic evaluation of the operability of pulmonary carcinoma
Acta Otolaryngol
Cytological investigation of intrathoracic lymph nodes in carcinoma of the lung
Thorax
Die bedeutung der zytodiagnostik der perbronchialen feinnadelpunktion von mediastinalen oder hilaren tumoren
Dtsch Med Wschr
Transbronchial fine needle aspiration
Thorax
Bronchoscopic needle aspiration biopsy of paratracheal tumors
Am Rev Respir Dis
Transbronchial needle aspiration in the diagnosis and staging of bronchogenic carcinoma
Am Rev Respir Dis
Cited by (278)
Flexible Bronchoscopy
2018, Clinics in Chest MedicineCitation Excerpt :Kato Oho first developed a needle that could be used through the flexible bronchoscope for the aspiration of paratracheal pathology in 1979, 1 year after Ko-Pen Wang first demonstrated the technique of mediastinal TBNA with the use of the rigid bronchoscope. These monumental achievements forever expanded the role of the bronchoscopist beyond disease of the airways, and were an essential step in the development of modern linear endobronchial ultrasound (EBUS) imaging.18–20 Numerous advanced modalities have been developed, expanding the role of the bronchoscopist for both diagnosing and treating diseases of the airways and lungs.
Malignancy risk associated with the EBUS-FNA diagnostic categories nondiagnostic, benign, atypical, suspicious for malignancy, and malignant for mediastinal lymph node aspirate specimens
2015, Journal of the American Society of CytopathologyCitation Excerpt :When a cytologic or histologic diagnosis of non–small cell carcinoma is made, assessment of mediastinal nodes is important for cancer staging and subsequent treatment.1,2 While a variety of techniques are available for assessment of mediastinal lymphadenopathy including mediastinoscopy, endoscopic ultrasonography-guided transesophageal FNA and endobronchial ultrasonography-guided transbronchial FNA,3-9 2 meta-analyses10,11 have shown that EBUS-TBFNA has good sensitivity (86% [95% confidence interval (CI), 0.82-0.90]) and excellent specificity (100% [95% CI, 0.99-1.00]).10 VanderLaan et al.12 have compared the sensitivities, specificities, positive predictive values, and negative predictive values for the techniques useful in staging non–small cell lung cancers.
Clinical Aspects of Lung Cancer
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionQuantitative analysis of a novel DNA hypermethylation panel using bronchial specimen for lung cancer diagnosis
2023, International Journal of CancerHistorical eye: From traditional to endobronchial ultrasound-guided needle aspiration and beyond
2023, Current Opinion in Pulmonary MedicineApplication of transbronchial needle aspiration in diagnosis of tuberculosis in children
2022, Chinese Journal of Applied Clinical Pediatrics
Manuscript received February 28; revision accepted May 2.
Reprint requests: Dr. Wang, Respiratory Division, Brady 4, The Johns Hopkins Hospital, Baltimore 21205