Abstract
Background: Transbronchial needle aspiration (TBNA) is a classical technique for diagnosing mediastinal-hilar lymph node enlargement. However, the diagnostic value of conventional TBNA (cTBNA) is limited in small lymph nodes. Methods: Here, we generated an innovative multi-dimensional virtual lymph node map on top of Wang’s lymph node map using a Lungpoint Virtual Bronchoscopic Navigation System. Results: The virtual bronchoscopic navigation (VBN) system was combined with computed tomography (CT) images to generate extrabronchial, endobronchial, sagittal, coronal as well as horizontal views of the 11 intrathoracic lymph node stations and their adjacent tissues and blood vessels. We displayed the specific puncture site of each lymph node station. The 11 stations were divided into four groups: right mediastinal stations, left mediastinal stations, central mediastinal stations and hilar stations. Conclusion: The VBN system provides a precise view of the intrabronchial landmarks, which may increase the diagnostic accuracy of intrathoracic lymph node adenopathy and assist bronchoscopists with practicing TBNA.
Highlights
Transbronchial needle aspiration (TBNA) is a classical bronchoscopic technique for diagnosing benign and malignant mediastinal-hilar lymph node enlargement
The recommended TBNA puncture sites of particular lymph nodes were described in detail (Wang, 1994; Wang, 1995; Xia and Wang, 2013)
W5 station, right main bronchus
Summary
Transbronchial needle aspiration (TBNA) is a classical bronchoscopic technique for diagnosing benign and malignant mediastinal-hilar lymph node enlargement. Even with ultrasound guidance, the diagnostic yield of TBNA varies, largely due to the skill and experience of the operator (Rodriguez de Castro et al, 1997; Hsu et al, 2004). Multi-Dimensional Display of Lymph Nodes Map the operator can accurately locate the target lymph nodes is of great importance, and requires a comprehensive understanding of the anatomy of mediastinal-hilar lymph nodes. Wang’s map was proposed in 1994 and the targeted lymph nodes are located by airway landmarks under endoscopic view, which is more practical for practitioners (Wang, 1994). Transbronchial needle aspiration (TBNA) is a classical technique for diagnosing mediastinal-hilar lymph node enlargement. The diagnostic value of conventional TBNA (cTBNA) is limited in small lymph nodes
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