Performance characteristics and predictors of yield from transbronchial needle aspiration in the diagnosis of peripheral pulmonary lesions

ABSTRACT Background and objective:  Transbronchial needle aspiration (TBNA) is useful for diagnosing peripheral pulmonary lesions (PPL). However, TBNA is largely underused and the variables that may be related to its diagnostic usefulness have not been specifically studied. The aim of the present st...

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Published in:Respirology (Carlton, Vic.) Vic.), 2011-10, Vol.16 (7), p.1144-1149
Main Authors: TRISOLINI, ROCCO, CANCELLIERI, ALESSANDRA, TINELLI, CARMINE, PAIOLI, DANIELA, SCUDELLER, LUIGIA, FORTI PARRI, SERGIO NICOLA, LIVI, VANINA, BOARON, MAURIZIO, PATELLI, MARCO
Format: Article
Language:English
Subjects:
Aged
Biopsy, Needle - methods
Bronchi - pathology
Bronchoscopy - methods
bronchus sign
Female
Humans
Italy
lung cancer
Lung Neoplasms - diagnosis
Lung Neoplasms - pathology
lung nodule
Male
Multivariate Analysis
Prospective Studies
Sensitivity and Specificity
transbronchial lung biopsy
transbronchial needle aspiration
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Summary:ABSTRACT Background and objective:  Transbronchial needle aspiration (TBNA) is useful for diagnosing peripheral pulmonary lesions (PPL). However, TBNA is largely underused and the variables that may be related to its diagnostic usefulness have not been specifically studied. The aim of the present study was to evaluate the performance characteristics and predictors of yield from TBNA of PPL, and to compare the performance characteristics of different bronchoscopic sampling methods. Methods:  Consecutive patients with PPL were prospectively enrolled, and during the same examination, TBNA, transbronchial lung biopsy (TBLB) and bronchial washing (BW) were performed. Results:  Two hundred and eighteen PPL in 218 patients were sampled. TBNA was more sensitive (65%) than either TBLB (45%, P  2 cm, location in the middle lobe, and malignant nature are strong predictors of a positive TBNA result. In a large series of patients with peripheral pulmonary lesions, transbronchial needle aspiration was the single best method associated with successful diagnosis. Preference should be given to this method, especially for lesions lacking the bronchus sign on CT.
ISSN:1323-7799
1440-1843
DOI:10.1111/j.1440-1843.2011.02026.x