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[经支气管针吸活检术作为纵隔淋巴结肿大的诊断方法]

[Transbronchial needle aspiration as a diagnostic method of mediastinal adenopathy].

作者信息

Soja Jerzy, Szlubowski Artur, Wasowski Dariusz, Kuzdzal Jarosław, Zieliński Marcin, Sładek Krzysztof

机构信息

Oddział Inwazyjnej Diagnostyki i Leczenia Chorób Klatki Piersiowej.

出版信息

Przegl Lek. 2005;62(2):102-4.

Abstract

The aim of the study was to assess the diagnostic yield of transbronchial needle aspiration (TBNA) in mediastinal or hilar adenopathy in: sarcoidosis, tuberculosis and malignancy. Transbronchial needle aspiration was performed in 53 patients, preeceded by computed tomography (CT). In 22 patients (41,5%) TBNA enabled to diagnose 10 cases of sarcoidosis, 12 cases of neoplastic infiltrates of the lung. There were 31 cases undiagnosed by means of TBNA. In 24 patients the diagnosis was established by means of other methods like bronchoscopy with mucose biopsy (8 cases of sarcoidosis), transbronchial lung biopsy (4 cases of squamous cell carcinoma and adenocarcinoma, 2 cases of sarcoidosis), mediastinoscopy (3 cases of sarcoidosis and 2 cases of Hodgkin's disease), and videothoracoscopy (2 cases of sarcoidosis), transthoracic needle biopsy (1 case of squamous cell carcinoma) and lymph node biopsy (1 case of adenocarcinoma and 1 case of sarcoidosis). In the remaining 7 patients who were followed-up for a period of one year the diagnosis of sarcoidosis was confirmed by clinical, radiological and cytological (BAL) examinations. Transbronchial needle aspiration was shown to be efficient diagnostic method in mediastinal or hilar adenopathy in sarcoidosis and malignancy except lymphoma. Moreover in approximately 60% of cases this technique doesn't allow to establish a diagnosis and in turn implicates the necessity for further diagnostic procedures like mediastinoscopy, or transbronchial or thoracoscopic lung biopsy.

摘要

本研究的目的是评估经支气管针吸活检术(TBNA)在结节病、结核病和恶性肿瘤所致纵隔或肺门淋巴结肿大中的诊断价值。对53例患者在进行计算机断层扫描(CT)后实施经支气管针吸活检术。22例患者(41.5%)经TBNA确诊,其中结节病10例,肺部肿瘤浸润12例。另外31例经TBNA未能明确诊断。24例患者通过其他方法确诊,如支气管镜黏膜活检(结节病8例)、经支气管肺活检(鳞状细胞癌和腺癌4例,结节病2例)、纵隔镜检查(结节病3例,霍奇金病2例)、电视胸腔镜检查(结节病2例)、经胸针吸活检(鳞状细胞癌1例)及淋巴结活检(腺癌1例,结节病1例)。其余7例患者随访1年,经临床、影像学及细胞学(支气管肺泡灌洗)检查确诊为结节病。结果显示,除淋巴瘤外,经支气管针吸活检术是诊断结节病和恶性肿瘤所致纵隔或肺门淋巴结肿大的有效方法。此外,在大约60%的病例中,该技术无法明确诊断,因此需要进一步采取纵隔镜检查、经支气管或胸腔镜肺活检等诊断措施。

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