TBNA Versus TENA in the Diagnosis and Staging of Bronchogenic Carcinoma: “A Comparative Study”

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Transbronchial needle aspiration (TBNA) through the flexible bronchoscope still remains underused and a poorly understood procedure. Recently, transesophageal needle aspiration (TENA) under ultrasound guidance has been used to help stage the posterior mediastinal lymph nodes. TBNA and TENA have both been used for the diagnosis and staging of bronchogenic carcinoma. This study is to compare the efficacy and complimentary potential of these techniques. Retrospective review and comparison of a series of consecutive patients. Tertiary referral hospital. Nineteen adult patients with mediastinal adenopathy. TBNA and TENA. Specific diagnostic yield of TBNA compared with TENA in adenopathy of the left paratracheal and subcarinal locations. Out of 19 patients, specific diagnosis was made in 15 patients (79%) by TBNA and in 13 patients (68%) by TENA. TBNA and TENA were both positive in 5 patients. TBNA alone was positive in 7 patients and TENA alone was positive in 1 patient. In the comparative study group lymph node stations 7, 8, and 5 (L4), there were no significant differences in the diagnostic yield of TBNA and TENA. Small sample size. TBNA remains highly effective for sampling mediastinal lymph node stations. TENA is limited for subcarinal, paraesophageal, and aorto-pulmonary window lymph nodes, which are adjacent to the esophagus. Adding TENA to TBNA did not increase the diagnostic yield even in these subgroups of lymph nodes in our study.