Transbronchial needle aspiration in undiagnosed radiographic shadows.

ABSTRACT

Background: Transbronchial needle aspiration (TBNA) is diagnostic in benign and malignant pulmonary lesions. The technique of TBNA has made mediastinal and hilar nodes accessible. In addition to its usefulness in central airway lesions, TBNA has been found to increase the diagnostic yield in peripheral lesions also. Aim: To evaluate the role of transbronchial needle aspiration (TBNA) in cases of unconfirmed radiographic shadows. Material and Methods: A detailed clinical history was recorded in all the 54 patients, who presented with an unconfirmed radiographic shadow. Thereafter, fibreoptic specimens of bronchial aspirate and TBNA were collected, and subjected to Ziehl-Neelsen staining, Graim’s staining, fungal smear, culture for pyogenic organisms and acid fast bacilli and cytological examination by H & E stain and Papanicolaou staining.Bronchial biopsy was collected in cases wherever feasible and specimens were paraffin embedded cut into 3-5 mm thickness and stained with H & E stain. Results: Out of 54, 48.1% were diagnosed to be having bronchogenic carcinoma, 20.4% each pneumonia and tuberculosis, while one patient had primary fungal infection (Candida abbicaus). The overall diagnostic yield was highest with TBNA (85.2%) followed by transbronchial biopsy (48.2%) and bronchial aspiration (42.7%) cases. Conclusion: TBNA offers an unique opportunity to make a pathological diagnosis at the time of bronchoscopy. It is equally effective in diagnosing various infective conditions like pneumonia and tuberculosis.