Transbronchial needle aspiration cytology (TBNA) in submucosal & peribronchial lesions: Sensitive, Superior & complimentary to Conventional diagnostic techniques during bronchoscopy in diagnosing lung cancer

Abstract

Background: Lung Cancer is the leading cause of cancer deaths around the world. Lung cancer accounts for 13.8% of all cancer diagnosis in India. Materials and Methods: prospective multicentric observational study conducted during July 2013 to September 2018 at bronchoscopy unit of MIMSR Medical College, and Venkatesh Chest Hospital Latur India to find role of TBNA submucosal & peribronchial lesions in confirming the diagnosis, to document additive yield of TBNA over other techniques like Bronchial Brush (BB), Bronchial wash (BW) and Forcep Biopsy (FB), and to observe any procedure related adverse events especially TBNA in peribronchial lesions. The study included 350 patients on the basis of clinical and radiological features of malignancy. Bronchoscopic lesions were categorized as submucosal lesions (SML) and peribronchial lesions (PBL). TBNA, FB, BB and BW were performed in all the cases during FOB. Results: Bronchoscopic abnormalities were documented as SML in 200 cases and PBL in 150 cases. In SML, diagnostic yield of TBNA & FB were 40.05% and 49.50% respectively. Additional diagnostic yield of other CDTs like BB and BW has nil effect on yield difference over forcep biopsy (P>0.11). In PBL, diagnostic yield of TBNA, FB & CDTs were 68.66%, 27.33% and 41.33% respectively. Additional CDTs like BB cytology and BW has additive yield to FB from 27.33% to 41.33% in PBL (P<0.00001). Sensitivity of TBNA in PBL is 96.19% while that of CDTs is 59 (P<0.00001). Conclusions: TBNA in submucosal lesions is complimentary to conventional diagnostic techniques in diagnosis of these lesions. TBNA in peribronchial lesions is most sensitive modality over conventional techniques and considered as ‘gold standard’ in these lesions. Received: May 12, 2019; Accepted: June 20, 2019; Published: June 24, 2019 European Journal of Respiratory Medicine 2019; 1(1): 105 110. doi: 10.31488/ejrm.102 Eur J Respir Med,1:1 European Journal of Respiratory Medicine Patil Shital*1 , Rajesh Patil2 , Ayachit Rujuta3 1. Associate Professor, Pulmonary Medicine, MIMSR Medical College, Latur, India 2. Associate Professor, Internal Medicine, MIMSR Medical College, Latur, India 3. Professor, Histopathology & Oncopathology, MIMSR medical College, Latur, India Transbronchial needle aspiration cytology (TBNA) in submucosal & peribronchial lesions: Sensitive, Superior & complimentary to Conventional diagnostic techniques during bronchoscopy in diagnosing lung cancer