Transbronchial needle aspiration of central and peripheral lesions

Transbronchial needle aspiration (TBNA) is a modality that allows us to sam ple tissue from the deeper submucosa as well as from the close extraluminal areas of the endobronchial tree. Tissue can be obtained for either cyto- o r histological examination, and the diagnosis of malignant as well as benig n conditions, including mycobacterial infection can be made, increasing the yield of the flexible bronchoscopy. The procedure reduces need for mediast inoscopy, and in some cases that for thoracotomy, improving patient welfare and reducing cost of the medical care. Despite its proven value, the modal ity remains underutilized by the modern day bronchoscopists. In this chapte r, we provide an up-to-date review of the TBNA literature and discuss reaso ns for perceived concerns, indications, the technique itself and precaution s against damage to the flexible bronchoscope. We believe that the reader o f the chapter would get a better understanding, greater confidence and impr oved yield related to this important diagnostic tool.