[Diagnostic yield of tran bronchial needle aspiration in mediastinal adenopathies]

ABSTRACT

Transbronchial needle aspiration [TBNA] is a minimally invasive alternative technique for evaluating mediastinal adenopathies. Transbronchial needle aspiration has proved its efficacy, safety, and cost-effectiveness in diagnosing and staging bronchogenic carcinoma as well as in diagnosing benign diseases such as sarcoidosis and tuberculosis. To evaluate the diagnostic yield of transbronchial needle aspiration in mediastinal adenopathies. The final diagnosis was evaluated for 122 patients investigated in division of chest diseases in Internal Medicine in Al-mowassat Hospital, Damascus University. Age of patients ranges 18-74 years.The technique was performed in cases of mediestinale denopathies confirmed by chest CT and non diagnosed by other procedures. we used standard flexible bronchoscopy model Olympus with 21 gauge needle for cytological examination. All patients had simple chest X.Ray and chest CT. 55 cases diagnosed by TBNA out of 99 cases [55,55%], 52 cases were malignant, and 3 cases were benign. . Diagnosis included 41 cases carcinoma [26 NSCC, 14 SCC, 1 metastase], 8 lymphoma, 2 malignancy, 1 thymoma. Transpronchial needle aspiration was negative in 29 cases of malignancy confirmed by other procedures. 23 cases dropped because of inadecuate penetration [7 cases], discharged against medical advise [6 cases] and inadecuate information [10 cases]. 18 cases were benign, 3 cases of theme diagnosed by TBNA [16,66%]. This study demonstrate that TBNA is a minimally invasive diagnostic technique with a high yield in the diagnosis of mediastinal adenopathies. Malignancy and type of malignancy are major determinants of TBNA yield. TBNA based on CT should be considered an integral part of the bronchoscopic examination when evaluating patients for mediastinal adenopathies