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
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