The role of transcarinal needle aspiration in the diagnosis and staging of lung cancer: computed tomographic correlates of a positive result
| Autor: | M. Ando, Hideo Saka, Chieko Sako, Masahide Oki, Akifumi Kumazawa, Atsushi Watanabe |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Neoplasms Bronchi Computed tomographic Bronchoscopy medicine Humans Prospective Studies Lung cancer Neoplasm Staging medicine.diagnostic_test business.industry Respiratory disease Biopsy Needle medicine.disease Endoscopy Trachea Lung disease Subcarinal Radiography Thoracic Radiology Lymph Nodes business Tomography X-Ray Computed |
| Zdroj: | Respiration; international review of thoracic diseases. 71(5) |
| ISSN: | 0025-7931 |
| Popis: | Background: Transbronchial needle aspiration (TBNA) is used most frequently to assess subcarinal nodes because of its technical ease. Objectives: We conducted a prospective observational clinical study to define the indications for TBNA use for subcarinal nodes (transcarinal needle aspiration, TCNA) related to the nodal size by computed tomography (CT) of the chest. Methods: One hundred and eight consecutive patients with lung cancer underwent TCNA at the time of initial diagnostic bronchoscopy within a 22-month period. Results: TCNA was positive in 21 of the patients. Only 1 of 75 patients (1%) with subcarinal nodes less than 10 mm in short-axis diameter by CT had a positive result. TCNA for enlarged nodes, 10 mm or greater, had a high positive yield of 61% (20/33). The procedure provided the only evidence of unresectable non-small cell lung cancer (stage IIIA-N2 disease) in 3 patients and the sole pathological evidence for malignancy in 5 patients. Conclusions: The high yield of positive TCNA results for enlarged subcarinal nodes contributes to the improvement of the overall diagnostic yield of bronchoscopy. We recommend that TCNA for enlarged subcarinal nodes on CT in patients with presumptive lung cancer should be performed routinely at the time of initial diagnostic bronchoscopy. |
| Databáze: | OpenAIRE |
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