Conventional method and ultrasound guided transbronchial needle aspiration techniques in the diagnosis of intrathoracic lymphadenopathies

Öz

Conventional transbronchial needle aspiration (TBNA) is one of the minimally invasive methods used for the diag­nosis of intrathoracic lymphadenopathies, which is an ef­fective, safe and cheap bronchoscopic technique. Endo­bronchial ultrasound (EBUS) guided TBNA is one of the most important advances in pneumology in recent years and has extended the diagnostic spectrum of broncho­scopic techniques. Today there are two different types of ultrasound probes for use with EBUS: radial and convex. The most important advantage of convex probe EBUS is that it allows real-time imaging while sample taken. To increase the diagnostic success, expansion of both con­ventional and ultrasound guided TBNA applications may reduce the need for invasive surgical procedures.

Anahtar Kelimeler

• Intrathoracic lymphadenopathies, transbron­chial needle aspiration, endobronchial ultrasound

İntratorasik lenfadenopatilerin tanısında konvansiyonel yöntem ve ultrason rehberliğinde transbronşiyal iğne aspirasyonu teknikleri

Öz

İntratorasik lenfadenopatilerin tanısında kullanılan mi­nimal invaziv yöntemlerden konvansiyonel transbron­şiyal iğne aspirasyonu (TBİA) etkili, güvenli ve ucuz bir bronkoskopi tekniğidir. Son yıllarda pnömonolojideki en önemli gelişmelerden olan endobronşiyal ultrason (EBUS) rehberliğinde TBİA ise bronkoskopik tekniklerin tanı spektrumunu genişletmiştir. Günümüzde radial ve konveks problu olmak üzere iki farklı EBUS cihazı kulla­nılmaktadır. Konveks prob EBUS\'un en önemli avantajı örnek alınırken eş zamanlı görüntüye olanak sağlaması­dır. Tanısal başarının arttırılması için gerek konvansiyonel gerekse ultrason rehberliğindeki TBİA uygulamalarının yaygınlaşması invaziv cerrahi prosedürlere olan gereksi­nimi azaltabilir.

Anahtar Kelimeler

• İntratorasik lenfadenopatiler, transb­ronşiyal iğne aspirasyonu, endobronşiyal ultrason

Kaynakça

1. Herth FJF, Rabe KF, Gasparini S, Annema JT. Transbron- chial and transoesophageal (ultrasound guided) needle as- pirations for the analysis of mediastinal lesions. Eur Respir J 2006;(28):1264-75.
2. Piet AH, Lagerwaard FJ, Kunst PW, et al. Can mediastinal nodal mobility explain the low yield rates for transbron- chial needle aspiration without real-time imaging? Chest 2007; (131):1783-7.
3. Holty JE, Kuschner WG, Gould MK. Accuracy of transbron- chial needle aspiration for mediastinal staging of non-small cell lung cancer: a meta-analysis. Thorax 2005;(60):949- 55.
4. Toloza EM, Harpole L, Detterbeck F, McCrory DC. Invasive staging of non-small cell lung cancer: a review of the cur- rent evidence. Chest 2003;(123):157S-166S.
5. Wang KP, Terry PB. Transbronchial needle aspiration in the diagnosis and staging of bronchogenic carcinoma. Am Rev Respir Dis 1983;(127):344-7.
6. Cetinkaya E, Yildiz P, et al. Transbronchial needle aspiration in the diagnosis of intrathoracic lymphadenopathy. Respira- tion 2002;69(4):335-8.
7. Bilaceroglu S, Chhajed P. Transbronchial needle aspiration: a diagnostic tool in routine bronchoscopy. J Assoc Physicians India 2005;(53):797-802.
8. Üskül TB. ve ark. Mediastinal Lenfadenopatisi Olan Akciğer Kanseri Olgularında Transbronşiyal İğne Aspirasyonunun Tanısal Değeri. Türk Toraks Dergisi 2008;9(3):99-103.

9. Chin R, McCain TW, Lucla MA, et al. Transbronchial nee- dle aspiration in diagnosing and staging lung cancer. How many aspirates are needed? Am J Respir Crit Care Med 2002;(166): 377-81.
10. Herth F, Becker HD, Ernst A. Conventional vs endobron- chial ultrasound-guided transbronchial needle aspiration: a randomized trial. Chest 2004;(125):322-5.
11. Gomez M, Silvestri GA. Endobronchial Ultrasound fort the diagnosis and staging of Lung Cancer. Proc Am Thorac Soc 2009;6(2):180-6.
12. Schenk DA, Chambers SL, Derdak S, et al. Compari- son of the Wang 19 gauge and 22 gauge needles in the mediastinal staging of lung cancer. Am Rev Respir Dis 1993;(147):1251-8.
13. Dasgupta A, Mehta AC. Transbronchial needle aspiration. An underused diagnostic technique. Clinics in Chest Medi- cine 1999;(20):39-51.
14. Wang KP, Haponik EF, Gupta PK, Erozan YS. Flexible transbronchial needle aspiration: technical considerations. Ann Otol Rhinol Laryngol 1984;(93):233-6.
15. Shure D, Fedullo PF. The role of transcarinal needle as- piration in the staging of bronchogenic carcinoma. Chest 1984;(86):693-6.
16. Harrow EM, Abi-Saleh W, Blum J, et al. The utility of trans- bronchial needle aspiration in the staging of bronchogenic carcinoma. Am J Respir Crit Care Med 2000;(161):601-7.
17. Diette GB, White P Jr, Terry P, Jenckes M, Rosenthal D, Rubin HR. Utility of on-site cytopathology assessment for bronchoscopic evaluation of lung masses and adenopathy. Chest 2000;(117):1186-90.
18. Haponik EF, Shure D. Underutilization of transbronchial needle aspiration. Experience of current pulmonary fel- lows. Chest 1997;(112):251-3.
19. De Castro FR, Diaz Lopez F, Serdà GJ, Lopez AR, Gilart JF, Navarro PC. Relevance of training in transbronchial fine- needle aspiration technique. Chest 1997;(111):103-5.
20. Raveglia F, Meda S, Conforti S, et al. Diagnostic value and learning curve of transbronchial needle aspiration in tho- racic surgery. Minerva Chir 2006;61(6):459-66.
21. Gompelmann D, Eberhardt R, Herth FJ. Endobronchial ul- trasound. Radiologe 2010;50(8):692-8.
22. Medford AR. Endobronchial ultrasound-guided trans- bronchial needle aspiration. Pol Arch Med Wewn 2010; 120(11):459-67.
23. Kurimoto N, Murayama M, Yoshioka S, Nishisaka T, Inai K, Dahi K. Assessment of usefulness of endobronchial ul- trasonography in determination of depth of tracheobron- chial tumor invasion. Chest 1999;(115):1500-6.
24. Herth FJ, Ernst A, Schulz M, Becker HD. Endobronchial ul- trasound reliably differentiates between airway infiltration and compression by tumor. Chest 2003;(123):458-62.
25. Herth FJ, Ernst A, Becker HD. Endobronchial ultra- sound guided transbronchial lung biopsy in solitary pul- monary nodules and peripheral lesions. Eur Respir J 2002;(20):972-5.
26. Yasufuku K, Chiyo M, Sekine Y, et al. Real-time endo- bronchial ultrasound-guided transbronchial needle as- piration of mediastinal and hilar lymph nodes. Chest 2004;126(1):122-8.
27. Herth FJ, Ernst A, Eberhardt R, Vilmann P, Dienemann H, Krasnik M. Endobronchial ultrasound-guided transbron- chial needle aspiration of lymph nodes in the radiologically normal mediastinum. Eur Respir J 2006;28(5):910-4.
28. Herth F, Becker HD, LoCicero J 3rd, Ernst A. Endobron- chial ultrasound in therapeutic bronchoscopy. Eur Respir J 2002;20(1):118-21.