Diagnostic Value of Transbronchial Needle Aspiration in Lung Cancer Patients with Mediastinal Adenopathy

Introduction: The aim of this study was to investigate the diagnostic value of transbronchial needle aspiration (TBNA) in lung cancer patients with mediastinal adenopathy. Material and Method: Patients with absolute and/or suspected lung cancer, and patients who underwent TBNA for diagnosis and/or mediastinal staging between December 2005-December 2006 were recorded. TBNA were performed on the lymphadenopathies, whose short diameter in contrasted thorax computerized tomography (CT) was bigger than 1cm, in paratracheal and subcarinal localizations. TBNA procedures were performed 22-gauge Wang needle. All tissues were assessed by the same pathologist blinded to patient data. Results: Mean age was 59.9 +/- 8.6 in 52 cases composed of 47(90%) male, and 5(10%) female. 72 mediastinal TBNA samples obtained from 52 cases. 36 (50%) of the 72 lymph node stations were in the right paratracheal, 7(10%) were in the left paratracheal and 29(40%) were in the subcarinal localization. Mean lymphadenopathy diameter in CT was 16.7 +/- 7.2 mm. Of samples obtained by TBNA, 90% were pathologically adequate. Overall sensitivity of TBNA was 87% and the diagnostic accuracy % 88. No statistical difference was found between diagnostic accuracy and sensitivity according to lymph node localization, size and histopathological diagnosis. No complication due to TBNA occurred. Conclusion: TBNA performed with a Wang 22-gauge needle is an effective and safe way of obtaining cytologic specimens from malignant mediastinal lymph nodes and can rapidly provide a diagnosis. Hopefully, this technique will reduce further need for more invasive surgical procedures.