THE ROLE OF TRANSBRONCHIAL NEEDLE ASPIRATION IN THE DIAGNOSIS OF PERIPHERAL LUNG MASSES OR NODULES

The purpose of this study was to evaluate the role of transbronchial n eedle aspiration (TBNA) in the diagnosis of peripheral lung lesions. W e attempted to perform TBNA in 37 patients referred to our hospital fo r diagnostic evaluation of radiographically evident peripheral masses (23 cases) or nodules (14 cases), None of them had bronchoscopic evide nce of endobronchial lesion, The aspirations were performed under fluo roscopic guidance, through a fibreoptic bronchoscope, employing a 21-g auge, 1.3 cm aspirating needle, They were preceded by bronchial brushi ng and followed by transbronchial biopsy (TBB) of the peripheral lesio n, In two cases, the apical nodules were not accessible by any of thes e procedures, Bronchial washings were also collected immediately after each procedure (brush, TBNA and TBB). TBNA was diagnostic in 23 of 37 patients (62%) rendering the TBNA yield considerably higher than wash ing (24%), brushing (27%) or TBB (38%), The addition of TBNA to the co mbination of TBB, brushing and washing, significantly increased the yi eld of fibreoptic bronchoscopy in our series from 46% to 70%, No signi ficant complications, such as pneumothorax or major bleeding, occurred either with TBNA or TBB. In conclusion, our findings suggest that tra nsbronchial needle aspiration is a safe procedure, that can improve th e diagnostic yield of bronchoscopy in the diagnosis of peripheral lung masses or nodules.