Conventional TBNA with 19 G TBNA Needle in Diagnosis of Mediastinal Lymph Nodes – Diagnostic Yield and Safety with 19G TBNA Needle

Introdution: As the practice of TBNA becomes more widelyaccepted, it has also revived a longstanding question on theoptimum size of needle and whether larger needle with corebiopsy is of any additional benefit. In routine practice 19Gneedle is rarely used even in large nodes as it is perceivedto be technically difficult and likely to give a poor yield ofrepresentative tissue. We report our experience with yield andsafety using 19G needle for Conventional TBNA.Material and methods: Eighteen patients with largemediastinal nodes (short axis > 25 mm) underwent 19GConventional TBNA and station 4R and/or stations 7 werepunctured respectively.Results: Out of Eighteen patients, core biopsy material wasinadequate or unrepresentative in 14 / 18 cases and cytologymaterial was unrepresentative in 2 patients. A diagnosiswas reached in 16 of 18 patients by smear cytology and in14 cases by histology. Out of eighteen patients, 12 patientshad Granulomatous etiology, 2 had poorly differentiatedadenocarcinoma, 1 had Malignant Round Cell Tumor, and onepatient had reactive lymphadenitis.Conclusion: The 19G TBNA procedure is effective and safe,and can be a cost-saving alternative to surgical mediastinalexploration. It should be performed after careful case selectionduring initial diagnostic bronchoscopy and familiarizationwith the technique should not be neglected in trainingprogrammes and workshops.

Oral verruca vulgaris: report of two rare cases and review.

Varieties of verrucous and papillary lesions affect skin as well as oral mucosa. These are either benign or reactive. Verruca vulgaris is one of the most commonly observed skin growths, widely known as “wart” and a lesion of childhood. Intraoral warts can occur at any age but are most commonly seen in age group of 30-50 years with equal incidence in both genders. It is found commonly on the palate followed by lip, tongue, buccal mucosa and rarely seen on gingiva. Conservative surgical excision with safe margins is the treatment of choice. Two rare case reports of Verruca vulgaris present on very rare intra oral site, gingiva have been discussed in this article. Key message: Papillary and verrucous lesions are not uncommon in oral cavity but reported cases of oral Verruca vulgaris are very rare. Gingiva is again a very rare site for oral warts.