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Correspondence |

Rapid On-site Evaluation of Transbronchial Aspirates in Mediastinal Adenopathy DiagnosisRapid On-site Evaluation of Transbronchial Aspirate FREE TO VIEW

Andrew R. L. Medford, DM, FCCP
Author and Funding Information

From the North Bristol Lung Centre, Southmead Hospital.

Correspondence to: Andrew R. L. Medford, DM, FCCP, North Bristol Lung Centre, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, England; e-mail: andrew.medford@hotmail.com


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(2):559-560. doi:10.1378/chest.11-0508
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To the Editor:

The results of the randomized trial by Trisolini et al1 in a recent issue of CHEST (February 2011) are noted with interest. It is perhaps surprising that rapid on-site evaluation (ROSE) did not result in an increased diagnostic yield for transbronchial needle aspiration (TBNA) because the same number of needle attempts per lymph node for TBNA were performed (four each), and ROSE has been shown to improve sample quality.2 One possible explanation is that because the TBNA bronchoscopists were highly skilled and operating in a specialized center, this resulted in a high yield in the non-ROSE group (>75%), preventing a significant increase in yield with ROSE over and above this finding. Another possibility, however, could be that a higher proportion of TBNA samples were taken with a 19-gauge needle (rather than 22 gauge) in the TBNA vs the TBNA+ROSE group, because a histology-gauge TBNA needle gives superior results to a cytology-gauge needle.3 Can the authors provide any further information on the relative proportion of needle gauges used in each arm of the study to eliminate this possibility?

Trisolini R, Cancellieri A, Tinelli C, et al. Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy: a randomized trial. Chest. 2011;1392:395-401. [CrossRef] [PubMed]
 
Hsu LH, Liu CC, Ko JS. Education and experience improve the performance of transbronchial needle aspiration: a learning curve at a cancer center. Chest. 2004;1252:532-540. [CrossRef] [PubMed]
 
Schenk DA, Chambers SL, Derdak S, et al. Comparison of the Wang 19-gauge and 22-gauge needles in the mediastinal staging of lung cancer. Am Rev Respir Dis. 1993;1475:1251-1258. [PubMed]
 

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References

Trisolini R, Cancellieri A, Tinelli C, et al. Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy: a randomized trial. Chest. 2011;1392:395-401. [CrossRef] [PubMed]
 
Hsu LH, Liu CC, Ko JS. Education and experience improve the performance of transbronchial needle aspiration: a learning curve at a cancer center. Chest. 2004;1252:532-540. [CrossRef] [PubMed]
 
Schenk DA, Chambers SL, Derdak S, et al. Comparison of the Wang 19-gauge and 22-gauge needles in the mediastinal staging of lung cancer. Am Rev Respir Dis. 1993;1475:1251-1258. [PubMed]
 
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