PURPOSE:To demonstrate the usefulness of real time guidance with CT fluoroscopy to improve the yield of transbronchial needle aspiration (TBNA).
METHODS:Thirteen patients with mediastinal lymphadenopathy were selected from our outpatient population and CT Fluoroscopy guided TBNA was performed on a 64 slice CT scanner (Aquilion TSX-101A, Toshiba Medical Systems Corporation, Japan.).
RESULTS:CT fluoroscopic guided transbronchial needle aspirations (TBNA) were performed on 13 patients with mediastinal adenopathy. Tissue specimens were obtained in all 13 patients. Three were positive for malignant disease, another 3 positive for necrotizing granulomatous inflammation consistent with tuberculosis, and 1 showed granulomas consistent with sarcoidosis. In 6 patients CT Fluoroscopy guided TBNA was inconclusive.
CONCLUSION:CT fluoroscopic guidance makes TBNA, an easy and a safe procedure. The probability of providing adequate diagnostic material increases compared to blind TBNA and should be considered for patients with relatively smaller lymphadenopathy in difficult stations.
CLINICAL IMPLICATIONS:CT fluoroscopy guided TBNA is likely to benefit bronchoscopists who have been hesitant to use TBNA because it provides a better road map for the procedure. CT Fluoroscopy is easy to perform and does not require special training such as for endobronchial ultrasound.
DISCLOSURE:Mansur Javaid, None.