Techniques of transbronchial needle aspiration and transbronchial needle biopsy
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Pneumon 2001;14(2):118-125
The role of fine-gauge (21,22-gauge) transbronchial needle aspiration (TBNA) in obtaining cytology specimen through flexible bronchoscope (FB) is well established. Indications extend from staging of bronchogenic carcinoma to diagnosis of bronchogenic cyst. However, the procedure is associated with certain limitations. These limitations do not exist with histological examination of the tissue obtained from the mediastinum or hilar areas using histology needle 19G through FB (TBNB). The first studies using this technique report good results, without complications in the majority of patients. Although current technology manufactured the system of needles to penetrate the tracheobronchial wall easily, problems sometimes occur. Therefore a combination of simple techniques, which are described below, is often necessary for a successful procedure. The overall diagnostic yield of TBNB by histology needle ranged from 52% to 72% in several studies. Furthermore, when histology was combined with cytology (flush specimen), the sensitivity increased to 86%. Even though the experience with TBNB is limited, we believe that it carries a great potential for acceptance as a routine staging procedure for bronchogenic carcinoma. It may become a procedure of choice for condition such as type I and II sarcoidosis, lymphoma, and other conditions presenting with mediastinal involvement, thereby limiting the need for mediastinoscopy. Pneumon 2001, 14(2): 118-125
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