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Clinical Investigations: LUNG CANCER |

Utility of Transbronchial Needle Aspiration in the Diagnosis of Endobronchial Lesions*

Asok Dasgupta, MBBS,; Prasoon Jain, MBBS, MD; Omar A Minai, MBBS; Sunder Sandur, MD; Yvonne Meli, RN; Alejandro C. Arroliga, MD, FCCP; Atul C. Mehta, MBBS, FCCP
Author and Funding Information

*From the Department of Pulmonary and Critical Care Medicine (Dr. Dasgupta), Kelsey-Sebold Clinic, Houston, TX, and the Department of Pulmonary and Critical Care Medicine (Drs. Jain, Minai, and Sandur, Ms. Meli, and Drs. Arroliga and Mehta), Cleveland Clinic Foundation, Cleveland, OH.

Correspondence to: Atul C. Mehta, MBBS, FCCP, Department of Pulmonary and Critical Care Medicine, Desk A-90, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195



Chest. 1999;115(5):1237-1241. doi:10.1378/chest.115.5.1237
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Background: The utility of transbronchial needle aspiration (TBNA) in visible endobronchial lesions presenting as either an exophytic mass lesion (EML) or submucosal and peribronchial disease (SPD) is not well established.

Objective: To compare the yield of conventional diagnostic procedures (CDP) (bronchial washing, bronchial brushing, and endobronchial forceps biopsy) with that obtained from a combination of CDP and TBNA (CDP + TBNA).

Design: Prospective study of 55 patients.

Setting: Tertiary-care referral hospital.

Results: Of the 55 patients in whom malignancy was confirmed, CDP + TBNA identified 53 (96%) vs 42 (76%) identified by CDP (p = 0.001). The highest yield from any individual procedure was obtained by TBNA. Of the 23 patients with SPD, 22 (96%) were diagnosed using CDP + TBNA compared with 15 (65%) by CDP (p = 0.016); the yield from TBNA alone (22 of 23) in this group surpassed the combined yield from all other procedures. Although no statistically significant difference in yield was observed for EML, the use of TBNA identified four additional patients compared with CDP.

Conclusion: We conclude that the addition of TBNA to CDP increases diagnostic yield in patients with visible endobronchial lesions.

Abbreviations:BB = brush biopsy; BW = bronchial washings; CDP = conventional diagnostic procedures; CDP + TBNA = combination of conventional diagnostic procedures and transbronchial needle aspiration; EBB = endobronchial forceps biopsy; EML = exophytic mass lesion; SPD = submucosal and peribronchial disease; TBNA = transbronchial needle aspiration

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