Ninety of a total of 549 patients undergoing diagnostic bronchoscopy met the criteria for inclusion in the study, with 66 patients exhibiting hilar-mediastinal lymphoadenopathies, and 24 patients demonstrating submucosal and/or peribronchial lesions. Of these 90 patients, 26 were women. The mean patient age was 57.4 years (range, 28 to 84 years). The following were sampled: hilar-mediastinal LN stations (n = 87), anterior carina (n = 10), posterior carina (n = 5), right paratrachea (n = 30), left paratrachea (n = 2), right main bronchus (n = 8), left main bronchus (n = 1), right upper hilar (n = 7), subcarina (n = 10), right lower hilar (n = 2), sub-subcarina (n = 2), left hilar (n = 9), and one right upper paratrachea (ATS station 2R) [Fig 1
, top, A], with a mean of 2.2 needle passes for each site sampled. Seventy-eight patients faced a malignant diagnosis. Seven patients had metastatic diseases such as esophageal cancer (two cases), breast cancer, cervical cancer, laryngeal cancer, nasopharyngeal cancer, and retroperitoneal cancer (one case each). Three patients featured lymphoma, and one patient demonstrated thymic carcinoma with metastases. The other 67 patients revealed a bronchogenic carcinoma comprising 52 non-small cell lung cancers (NSCLCs) and 15 small-cell lung cancers (SCLCs). TBNA revealed positive results for malignancy for 59 patients, including bronchogenic carcinoma (n = 50), metastatic carcinoma of extrapulmonary origin (n = 7), and lymphoma (n = 2). The cytologic examination reported the following: adenocarcinoma (n = 20), squamous cell carcinoma (n = 17), SCLC (n = 15), and undifferentiated carcinoma (n = 5). Sarcoidosis (Fig 2
), a mediastinal bronchogenic cyst (Fig 3
), and mediastinal tuberculous adenitis were identified by use of the MW319 needle, with one case of each condition being identified. For the hilar-mediastinal lesions, the diagnostic yield and process sensitivity were 68.2% (45 of 66 patients) and 75% (45 of 60 patients), respectively. For the submucosal and peribronchial lesions, the diagnostic yield and sensitivity were 70.8% (17 of 24 patients) and 80.9% (17 of 21 patients), respectively. Fifteen patients presenting mediastinal lesions attained to a specific pathologic diagnosis using TBNA despite normal-appearing airways. The right paratrachea LN was the most common site of aspiration, with diagnosis by this means being made for 18 of 30 patients. TBNA was exclusively diagnostic for 27 patients. Twenty-two patients had undergone previous bronchoscopy with indeterminate results at other hospitals prior to undergoing TBNA at our institution.