Wang K P
Chest. 1985 Dec;88(6):860-3. doi: 10.1378/chest.88.6.860.
Flexible transbronchial needle aspiration (TBNA) biopsy has been used to obtain cytologic specimens from mediastinal lymph nodes for the diagnosis and staging of bronchogenic carcinoma. The dependency on a sophisticated cytologic laboratory, the skill required to perform this procedure, and the inability to obtain enough tissue to diagnose noncarcinomatous processes in the mediastinum by smaller needles has limited its use. The application of TBNA would be greatly enhanced if a histologic specimen could be obtained from the mediastinal lymph node safely. For this reason, an 18-gauge needle was developed and used through a rigid bronchoscope. In ten patients, adequate tissue for histology was obtained in nine, and a specific diagnosis was made in eight patients without any complication. A similar technique was developed and is now reported using the flexible bronchoscope. We conclude that using a flexible transbronchial needle is an effective and safe way of obtaining histologic specimens from the mediastinum and can provide a diagnosis, both in malignant and benign mediastinal disease. Hopefully, this technique will further reduce the need for more invasive surgical procedures.
可弯曲经支气管针吸活检术（TBNA）已用于获取纵隔淋巴结的细胞学标本，以诊断支气管肺癌并进行分期。依赖复杂的细胞学实验室、实施该操作所需的技能以及无法用较细针获取足够组织来诊断纵隔非癌性病变，限制了其应用。如果能安全地从纵隔淋巴结获取组织学标本，TBNA的应用将得到极大加强。出于这个原因，研制了一种18号针并通过硬支气管镜使用。在10例患者中，9例获得了足够的组织用于组织学检查，8例患者做出了明确诊断，且无任何并发症。现报道一种类似的技术，使用可弯曲支气管镜。我们得出结论，使用可弯曲经支气管针是从纵隔获取组织学标本的有效且安全的方法，在恶性和良性纵隔疾病中均可提供诊断。有望这项技术将进一步减少对更具侵入性手术的需求。
