Diagnostic value of transbronchial needle aspiration for lesions in lung and mediastina with unobstructed bronchi

【Objective】 To evaluate diagnostic value of pulmonary or mediastinal lesions with unobstructed bronchi via transbronchial needle aspiration(TBNA).【Methods】 To analyze the results of 33 cases of pulmonary or mediastinal lesions with mediastinal lymph node enlargement but without obstructed or externally pressed bronchi via fiberoptic bronchoscope routinely.TBNA was performed for biopsy of enlarged lymph node.Bronchoscopy brush at the site of bronchus of TBNA was done in turn.If thickened focal mucus,congestion or edema were seen,biopsy in situ was done as well.We compared the positive rate of diagnosis of TBNA and bronchoscopy brush combined mucus biopsy,to evaluate the validity and security of TBNA and analyze its influencing factors.【Results】 Of 27 pulmonary space occupying lesions with mediastinal lymphonode enlargements,17 cases were diagnosed by TBNA,whose positive rate of diagnosis is 63.3%;while positive rate of diagnosis of TBNA in the lesions of simply mediastinal lymph node enlargement is 16.7%(1/6).The total positive rate of diagnosis of TBNA is 54.5%(18/33),higher than that of bronchoscopy brush combined mucus biopsy,which is 15.2%(5/33)(P 0.01).The influencing factors were the size and site of lymph nodes.Lymph nodes with the diameter larger than 2 cm produce higher positive rate of diagnosis of TBNA.In patients of pulmonary space occupying lesions,the mediastinal lymph node enlargement of Group seven produces higher positive rate than that of Group non-seven(P 0.05).Complications of TBNA are rare,most of which are only slight bleeding of the site of TBNA.【Conclusion】 TBNA is a safe and effective method to determine the diagnosis of lesions of lungs but outside the bronchi and lung hilar or mediastinal lymph node enlargement,especially when the bronchi are unobstructed.