TRANSTRACHEAL ASPIRATION USING RIGID BRONCHOSCOPY AND A RIGID NEEDLE FOR INVESTIGATING MEDIASTINAL MASSES

Background - Use of the flexible needle via the fibreoptic bronchoscop e to aspirate mediastinal nodes or masses has largely superseded the u se of the rigid needle via the rigid bronchoscope. However, the yield at fibreoptic bronchoscopy is relatively low, although this improves w ith the use of a wider gauge needle. In this study the sensitivity and the safety of rigid needle sampling of the mediastinum in the diagnos is of lung cancer is evaluated. Methods - Transtracheal needle aspirat ion (TTNA) was performed with the rigid bronchoscope and a rigid aspir ation needle under general anaesthesia using a previous computed tomog raphic (CT) scan as a guide to the sample site. A cytopathologist imme diately examined the specimens for adequacy and preliminary diagnosis, thus determining the number of aspirations. Results - Twenty four pat ients were evaluated. The diagnostic sensitivity of TTNA was 88%. This led to a management decision in 21 patients. There were no false posi tives and no complications. Conclusions - TTNA using the rigid broncho scope with CT scanning and a cytopathologist present is a sensitive an d safe way of diagnosing lung cancer in patients with a mediastinal ma ss or enlarged mediastinal nodes.