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Transbronchial Needle Aspiration

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Interventional Bronchoscopy

Part of the book series: Respiratory Medicine ((RM,volume 10))

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Abstract

Transbronchial needle aspiration (TBNA) is a technique in which a cytology or histology specimen is obtained during flexible bronchoscopy from beyond the confines of the endobronchial tree. Mediastinal staging of lung cancer is the most common indication for TBNA. The procedure is also useful in diagnosis of sarcoidosis and tuberculosis as the cause of mediastinal lymph node enlargement. The procedure is performed under conscious sedation and does not need expensive guiding or tracking devices. The procedure is cost-effective, is easy to learn, and has an excellent safety record. Unfortunately, many bronchoscopists never adopted this technique in their practice due to lack of training and widespread misconceptions about the usefulness and safety issues. Endobronchial needle aspiration (EBNA) is a related technique in which the 22-gauge needle is used to obtain cytology specimen from endoscopically visible lesion. EBNA increases the diagnostic yield from submucosal and peribronchial lung tumors. Peripheral TBNA (P-TBNA) is a technique in which a ­cytology specimen is obtained from a suspected malignant peripheral lung nodule under fluoroscopic guidance. Addition of P-TBNA to conventional sampling techniques improves diagnostic yield of bronchoscopy, especially in patients with Tsuboi type III or IV tumor bronchus relationship. The role of conventional TBNA has further become a topic of hot debates with the emergence of endobronchial ultrasound (EBUS)-guided TBNA. The authors believe that even in the era of EBUS-TBNA, the standard TBNA technique maintains an important position in the diagnosis and staging of lung cancer.

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Authors and Affiliations

  1. Pulmonary and Critical Care, Louis A Johnson VA Medical Center, Clarksburg, WV, 26301, USA

    Prasoon Jain M.B.B.S., M.D., F.C.C.P.

  2. Pulmonary and Critical Care Medicine, Wake-Forest School of Medicine, Winston-Salem, NC, USA

    Edward F. Haponik M.D.

  3. Section of Pulmonary, Critical Care, Environmental and Sleep, Carilion Clinic, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA

    A. Lukas Loschner M.D.

  4. Respiratory Institute, Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, 44195, USA

    Atul C. Mehta M.B.B.S.

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  1. Prasoon Jain M.B.B.S., M.D., F.C.C.P.
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Correspondence to Prasoon Jain M.B.B.S., M.D., F.C.C.P. .

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  1. , Pulmonary, Allergy and Critical Care Med, Cleveland Clinic, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Atul Mehta

  2. , Pulmonary and Critical Care Medicine, Louis A. Johnson VAMC, Medical Center Drive 1, West Virginia, 26301, USA

    Prasoon Jain

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Jain, P., Haponik, E.F., Loschner, A.L., Mehta, A.C. (2013). Transbronchial Needle Aspiration. In: Mehta, A., Jain, P. (eds) Interventional Bronchoscopy. Respiratory Medicine, vol 10. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-395-4_3

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