Thorac Cardiovasc Surg 2006; 54(2): 117-119
DOI: 10.1055/s-2005-865924
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Transbronchial Fine Needle Aspiration Cytological Examination: A Useful Tool for Diagnosing Primary Lung Cancer

A. Iyoda1 , M. Baba1 , K. Shibuya1 , Y. Moriya1 , K. Yasufuku1 , Y. Sekine1 , T. Iizasa1 , K. Hiroshima2 , Y. Nakatani2 , T. Fujisawa1
  • 1Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
  • 2Basic Pathology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
Further Information

Publication History

Received April 21, 2005

Publication Date:
15 March 2006 (online)

Abstract

Background: Obtaining a definitive preoperative diagnosis plays a critical role in deciding upon the treatment approach for lung carcinoma. However, success in making definitive diagnoses of small primary lung cancers will require new approaches because these cancers are difficult to detect using standard biopsy procedures. Methods: We evaluated the results of morphologic definitive diagnosis together with various clinical factors in 1003 primary lung cancers resected surgically. Patients underwent transbronchial brushing, fine needle aspiration cytology, forceps biopsy, and/or forceps biopsy-stamp cytology for preoperative diagnoses, in conjunction with the use of Diff-Quik to confirm that hits had been made on the radiographic shadows before terminating the examinations. Results: Sensitivities of the diagnostic procedures for primary lung cancers were as follows: 64.8 % for brushing, 56.1 % for transbronchial forceps biopsy, 72.0 % for transbronchial forceps biopsy-stamp cytology, and 86.4 % for transbronchial fine needle aspiration. The four transbronchial biopsy procedures had a combined overall sensitivity of 92.7 %. In patients with peripheral lung cancers of 2 cm or less in diameter, transbronchial fine needle aspiration had a sensitivity of 75.9 %, which was the highest sensitivity for all transbronchial examinations. In the subset of 296 patients who underwent all four transbronchial biopsy examinations, transbronchial fine needle aspiration had the highest sensitivity of preoperative diagnosis of all the transbronchial examination methods. Conclusions: The sensitivity of preoperative cytological diagnosis for primary lung cancers, especially transbronchial aspiration cytology, is high. Transbronchial fine needle aspiration cytology is useful for the preoperative diagnosis of primary lung cancer.

References

  • 1 Sone S, Li F, Yang Z G. et al . Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner.  Br J Cancer. 2001;  84 25-32
  • 2 Kaneko M, Kusumoto M, Kobayashi T. et al . Computed tomography screening for lung carcinoma in Japan.  Cancer. 2000;  89 2485-2488
  • 3 Khouri N F, Stitik F P, Erozan Y S. et al . Transthoracic needle aspiration biopsy of benign and malignant lung lesions.  AJR Am J Roentgenol. 1985;  144 281-288
  • 4 Conces D J, Schwenk R, Doering P R, Glant M D. Thoracic needle biopsy - improved results utilizing a team approach.  Chest. 1987;  91 813-816
  • 5 MacDonald L L, Yazdi H M. Fine-needle aspiration biopsy of bronchiolo alveolar carcinoma.  Cancer. 2001;  93 29-34
  • 6 Wagner E D, Ramzy I, Greenberg S D, Gonzalez J M. Transbronchial fine-needle aspiration. Reliability and limitations.  Am J Clin Pathol. 1989;  92 36-41
  • 7 Cappellari J O, Thompson III E N, Wallenhaupt S L. Utility of intraoperative fine needle aspiration biopsy in the surgical management of patients with pulmonary masses.  Acta Cytol. 1994;  38 707-710
  • 8 Sider L, Davis Jr T M. Hilar masses: Evaluation with CT-guided biopsy after negative bronchoscopic examination.  Radiology. 1987;  164 107-109
  • 9 Yoshikawa T, Yoshida J, Nishimura M, Yokose T, Nishiwaki Y, Nagai K. Lung cancer implantation in the chest wall following percutaneous fine needle aspiration biopsy.  Jpn J Clin Oncol. 2000;  30 450-452
  • 10 Iyoda A, Suzuki M, Chiyo M. et al . A new thin-type bronchoscope improves diagnostic accuracy of peripheral pulmonary carcinoma.  Oncol Rep. 2003;  10 387-389
  • 11 Baba M, Iyoda A, Yasufuku K. et al . Preoperative cytodiagnosis of very small-sized peripheral-type primary lung cancer.  Lung Cancer. 2002;  37 277-280

MD Takehiko Fujisana

Department of Thoracic Surgery
Graduate School of Medicine
Chiba University

1-8-1 Inohana

Chuo-ku, Chiba 260 - 8670

Japan

Phone: + 81432227171 (ext. 5464)

Fax: + 81 4 32 26 21 72

Email: fujisanat@faculty.chiba-u.jp