Clinical usefulness and cost-effectiveness of the transbronchial needle aspiration for the diagnosis of mediastinal lymph node enlargement

Transbronchial needle aspiration (TBNA) of mediastinal or hilar enlarged ly mph nodes is a usefull and safe technique. Nevertheless, its use has not be come widespread, and the necessity of a specific training to obtain good re sults has been reported. In order to evaluate the clinical usefulness and cost-efectiveness of TBNA in unexperienced brochoscopists in this technique, a prospective study was conducted of this technique used in all patients with a chest CT with parat racheobronchial lymph nodes larger than 10 mm who had a fiberbronchoscopy o rdered. TBNA was performed in 66 lymph node staging in 59 patiens. In 76% o f cases adequate specimens were obtaned, and a cytohistologic diagnosis was established in 59%. In 44% of patients, TBNA avoided other more invasive d iagnostic procedures. Had TBNA not been performed, cost was estimated to ha ve been at least five times higher. We conclude that TBNA could be a useful cost-effective technique in unexper ienced teams.