Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Cancer Cytopathol. 2020 May;128(5):333-340. doi: 10.1002/cncy.22240. Epub 2020 Jan 29.
Transbronchial needle aspiration (TBNA) of peripheral lung nodules can be difficult with conventional devices due to their limited flexibility. A promising new technology for accessing these lesions is the PeriView FLEX TBNA device, which has a flexible spiral-grooved needle. The present study reports the unique cytologic features, diagnostic value, and potential pitfalls of PeriView FLEX TBNA specimens.
This study retrospectively evaluates 113 consecutive cases of lung nodules sampled using the PeriView FLEX device with radial endobronchial ultrasound guidance.
PeriView FLEX specimens were satisfactory for evaluation in 111 of 113 cases (98%). A diagnosis of malignancy was made on 64 specimens (57%), with 100% specificity and 70% sensitivity for malignancy. In 4 cases, the PeriView FLEX sample was the only specimen from bronchoscopy that was diagnostic of malignancy. Of the 64 PeriView FLEX specimens with malignant cells, 58 (91%) were adequate for immunohistochemistry and 44 (69%) were adequate for molecular genetic testing. Potential pitfalls were largely ameliorated through education regarding the unique features of PeriView FLEX samples, such as the expected abundance of anthracotic pigment and the paucity of lymphocytes.
TBNA using the PeriView FLEX device to sample pulmonary nodules contributed to the diagnostic value of bronchoscopy and tended to provide sufficient tissue for ancillary studies. Many of the possible pitfalls may be avoided through consideration of the unique cytologic features associated with this novel sampling method.
由于常规设备的灵活性有限，经支气管针吸活检（TBNA）对周围肺结节的操作可能较为困难。一种有前途的新技术是 PeriView FLEX TBNA 设备，它具有灵活的螺旋槽针。本研究报告了 PeriView FLEX TBNA 标本的独特细胞学特征、诊断价值和潜在陷阱。
本研究回顾性评估了 113 例连续的肺结节病例，这些病例均使用 PeriView FLEX 设备在径向支气管内超声引导下进行采样。
113 例中有 111 例（98%）的 PeriView FLEX 标本评估结果满意。64 例（57%）诊断为恶性肿瘤，特异性为 100%，敏感性为 70%。4 例中，PeriView FLEX 样本是唯一可诊断恶性肿瘤的支气管镜样本。64 例有恶性细胞的 PeriView FLEX 标本中，58 例（91%）可用于免疫组织化学检查，44 例（69%）可用于分子遗传学检查。通过对 PeriView FLEX 样本的独特特征（如预期的大量炭末色素和淋巴细胞缺乏）进行教育，潜在的陷阱在很大程度上得到了缓解。
使用 PeriView FLEX 设备进行 TBNA 采样对支气管镜的诊断价值有贡献，并且往往可以提供足够的组织进行辅助研究。许多可能的陷阱可以通过考虑与这种新采样方法相关的独特细胞学特征来避免。
