Transbronchial needle aspiration (TBNA) in the early diagnosis and staging of bronchogenic carcinoma.

BACKGROUND: Transbronchial needle aspiration (TBNA) has evolved as a useful technique to establish diagnosis in patients suspected of having bronchogenic carcinoma. METHODS: Transbronchial needle aspiration (TBNA) was done in twenty-five patients with either proved or suspected bronchogenic carcinoma using a flexible bronchoscope. Results of 19 patients who had pulmonary malignancy were analysed. RESULTS: In the 12 patients with endobronchially visible abnormality, TBNA could correctly identify eleven patients with carcinoma and one patient, who was a treated case, with no evidence of residual disease. In the seven patients with bronchoscopically invisible extrabronchial disease, TBNA could identify four patients with malignancy and also characterize true negative disease in a treated case with subcarinal lymph node. TBNA could define the correct cytology in all the patients with visible tumours and in 59% of patients with bronchoscopically invisible tumours. The procedure was diagnostic in 84% of the cases. Mediastinal lymph node sampling in nine patients by TBNA, with the help of contrast enhanced CT scans, was positive in five patients and negative in the other four patients thus helping in nodal staging. CONCLUSIONS: Although the sample size of the study was small, the procedure was found to be very useful for the early diagnosis and staging of bronchogenic carcinoma. It was safe, well tolerated and no untoward complications were observed.

Amoebic liver abscess rupturing into the chest: ultrasonographic appearance.

Two cases of amoebic liver abscess perforating into chest are reported. Both patients were males in their twenties. They presented with right upper quadrant pain in abdomen in one case and right lower chest pain in second case. Ultrasonography demonstrated hypoechoic liver abscess in superior subdiaphragmatic part of the right lobe of liver, with communication through a hole in the diaphragm into the thoracic cavity in both the cases. Both these cases were diagnosed as cases of amoebic liver abscess perforated into chest on the basis of ultrasonographic findings and both of them showed good response to specific antiamoebic therapy.

Primary carcinoid tumour of trachea.

Tracheal carcinoid is a rare entity. A patient with a primary carcinoid tumour of trachea treated as a case of bronchial asthma for over a decade, is presented.

Chronic anaerobic pneumonitis.

A case of chronic anaerobic pneumonitis, without any predisposing factors, nor the classical features often associated with it, which masqueraded as pulmonary tuberculosis is described. Therapy with metronidazole resulted in striking improvement.