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21 May 2022 (Vol 45 , Iss 04 )

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31 May 2022 (Vol 45 , Iss 03 )

Journal ID : TMJ-14-12-2021-10888
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Title : Technical Factors and Lesion Characteristics Affecting Cytology Positivity in Conventional TBNA for Mediastinal Lymphadenopathy without ROSE

Abstract :

Conventional transbronchial needle aspiration (cTBNA) for mediastinal lymphadenopathy without rapid on-site cytological evaluation (ROSE) remains an essential diagnostic modality, especially in resource-limited settings. This study aims to determine the technical factors and lesion characteristics that influence positive cTBNA cytology. This is an observational study that utilized the primary data of station 4R and station 7 mediastinal lymphadenopathy patients based on chest CT scans at the Persahabatan Hospital, Jakarta, Indonesia, from November 2019 to February 2020. An analysis of lymph node sites, lymph node size, needle size, needle puncture method, TBNA sampling sets, and the number of needles passed with positive cytology results were performed. A total of 33 subjects underwent 33 cTBNA procedures on lymph nodes stations 7 and 4R. There were 20 positive TBNA results (60.6%) consisting of 18 malignant and two M. Tuberculosis infection cases. Station 7 lymph nodes had greater positive TBNA results than station 4R lymph nodes (75% and 47.1%, respectively). Lymph node sizes ≥30 mm had more positive TBNA results than lymph node size <30 mm (53.8% vs. 36.4%). 21G needles showed more positive cTBNA results than 19G needles (68.2% and 45.5%, respectively). The TBNA sampling 1-2 set group showed 55.6% positive cytology, while the TBNA sampling 3-4 sets group showed 66.7% positive cytology results. A total of 10-14 passes showed 70% positive cTBNA results, while 15-20 needles passed showed 56.5% positive TBNA results. 21G TBNA needle was associated with positive cTBNA cytology without ROSE.

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