RESUMO
Transbronchial needle aspiration (TBNA) via a fiberoptic bronchoscope has been used for diagnosis of lung cancer by Wang since 1981. The technique uses a fiberoptic bronchoscope with a flexible needle that can penetrate the wall of the trachea and major bronchi. It is still underutilized and markedly depends on the physician's skill. We present our experience of TBNA for diagnosis of bronchogenic carcinoma. TBNA was performed on 47 consecutive patients with suspected lung cancer at the time of diagnosis bronchoscopy. Thirty six patients were diagnosed with bronchogenic carcinoma. TBNA demonstrated bronchogenic carcinoma in 61.1 per cent of the cases (22 of 36) and TBNA alone confirmed a malignant diagnosis in 33.3 per cent (12 of 36). The overall diagnostic yield of bronchoscope utilizing the conventional techniques of bronchial washing, brushings and biopsy was 50 per cent. With the addition of TBNA, bronchoscopy was diagnostic in 83.3 per cent of the patients. There were no serious complications. We concluded that TBNA is a safe technique that can significantly increase the diagnostic yield of conventional fiberoptic bronchoscopy in the diagnosis of bronchogenic carcinoma.
Assuntos
Biópsia por Agulha/métodos , Broncoscopia/métodos , Carcinoma Broncogênico/patologia , Neoplasias Pulmonares/patologia , Adulto , Idoso , Carcinoma Broncogênico/diagnóstico , Carcinoma Broncogênico/mortalidade , Desenho de Equipamento , Feminino , Tecnologia de Fibra Óptica , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Taxa de SobrevidaRESUMO
Diffuse panbronchiolitis (DPB) is an important cause of progressive obstructive lung or chronic suppurative lung disease in the Far East (Japan, China and Korea). It is a distinctive sinobronchial syndrome with typical radiological and histologic features. We have identified three patients who have typical clinical manifestation and pathological confirmation. DPB should be suspected in patients who have clinical manifestations of chronic cough, productive sputum and shortness of breath. The chest radiograph often shows diffuse nodular shadows on a background of hyperinflated lungs. High resolution computed tomographic (HRCT) can guide the diagnosis and differentiate from other diseases. Finally, the most important issue of DPB is the treatment. Chronic treatment with low-dose erythromycin can improve the survival of patients.
