The present study was designed
to evaluate the diagnostic yield of
TBNA in the diagnosis of extrabronchial
and mediastinal lesions in order
to
avoid unnecessary mediastinoscopies
or other surgical procedures.
This study included thirty patients.
Twenty patients with clinical
and
radiological evidence of mediastinal
lymph node enlargement, and
ten
patients with extrabronchial
mass
lesion causing an extraluminal
compression
who were admitted to
Al
Hussien university hospital and
Bab
El-Shariah university hospital,
chest
department in the period between
May 2010 and May 2012. All
patients
wersubjected to the follow- ing: history taking, clinical examination,
plain chest X- ray posteroanterior
and lateral views, computerized
tomography of the chest with
contrast,
routine laboratory investigations,
fiberoptic bronchoscopy for inspection
of the tracheobronchial tree
and
biopsy using TBNA, histopathological
and cytological examination
of
the specimens. Some patients
needed
other investigations to confirm
or reach the diagnosis such as
mediastinoscopy,
C.T guided biopsy
and
limited thoracotomy.
The diagnostic yeild TBNA in diagnosis
of non-malignant lesions
was
75%, 33% in sarcoidosis, 100%
in
TB and non-specific inflammation,
and
77.7% in malignant lesions, 75% in lymphoma and 80% in metastasis,
and overall diagnostic yeild for mediastinal
lesions was 76.47%, sensitivity
for small cell carcinoma was
100.0%
and for non-small cell carcinoma
was 62.5%, 80.0% for adenocarcinoma,
0 for squamous cell carcinoma
and 100.0% for large cell
carcinoma.
The overall sensitivity for
extrabronchial
lesions was 70.0%.
Conclusion: transbronchial needle
aspiration provide a reasonable
and accurate method in diagnosis
of extrabronchial and mediastinal
lesions.