[Clinical utility of transbronchial needle aspiration of mediastinal lymph nodes in the diagnosis of XXXX in stages I and II].

@entity1 @entity370
OBJECTIVE: To analyze the individual and combined diagnostic yield and clinical utility of transbronchial needle aspiration and transbronchial biopsy in the histologic diagnosis of @entity370 in stages I and II. @entity1 AND METHODS: We performed a prospective study enrolling all the @entity1 admitted to our hospital between July 2001 and June 2006 with mediastinal lymph nodes of a diameter of over 10 mm and clinical and radiological indication of @entity370 . The @entity1 underwent the following tests in the order specified: a transbronchial needle aspiration of 1 or more lymph nodes using a 19-gauge histology needle until 2 satisfactory specimens were obtained, a bronchoalveolar lavage, and 4 to 6 transbronchial biopsies. RESULTS: A total of 32 @entity1 were enrolled during the study period. Of these, 26 were finally diagnosed with @entity370 . The mean (SD) age of the @entity1 was 38.9 (10.6) years and there were 13 @entity1 (50%). The mean (SD) lymph node diameter was 23.5 (6.5) mm. The most common lymph node aspiration sites were the subcarinal station (9 @entity1 , 34.6%) and a combination of the subcarinal and paratracheal stations (7 @entity1 , 26.9%). Computed tomography scans of the chest revealed parenchymal involvement in 12 (46.2%) @entity1 . Fifteen (57.7%) @entity1 were diagnosed by transbronchial biopsy and 16 (61.5%) by transbronchial needle aspiration. These techniques were used in isolation in 7 (26.9%) and 8 (30.8%) @entity1 , respectively (P>.05). Diagnosis was achieved with the combined results of transbronchial biopsy and needle aspiration in 23 (88.4%) @entity1 . Overall, the diagnostic yield of the combined techniques was significantly higher than that of either one in isolation (P=.01 vs transbronchial biopsy and P=.02 vs needle aspiration). In @entity1 with parenchymal involvement, yield was better for the combined techniques only in comparison with transbronchial biopsy (P=.01). Only 4 (15%) @entity1 developed complications and 20 (76.9%) tolerated the procedures well. CONCLUSIONS: Diagnostic yield was significantly higher when transbronchial biopsy and transbronchial needle aspiration were used in combination than when used alone, particularly in @entity1 without parenchymal involvement. There were few complications and tolerance was good.
