Transbronchial needle aspiration of hilar and mediastinal lymph nodes
Punção aspirativa transbrônquica por agulha de linfonodos hilares e mediastinais
Deborah Lannes1, Andréia Salarini Monteiro1, Edson Toscano2, Aureliano Cavalcanti3, Marilene Nascimento4, Paulo de Biasi5, Mauro Zamboni6,
1 Pneumologista do Grupo de Oncologia Torácica – Hospital do Câncer – HC I – INCA/MS / Pulmonologist, Thoracic Oncology Group - Hospital do Câncer – HC I – INCA/MS
2 Cirurgião de Tórax do Grupo de Oncologia Torácica – Hospital do Câncer – HC I – INCA/MS. Título de Especialista pela SBCT. Mestre em Cirurgia Torácica pela Universidade Federal Fluminense / Thoracic Surgeon, Thoracic Oncology Group – Hospital do Câncer – HC I – INCA/MS. Specialist, SBCT. MSc in Thoracic Surgery, Universidade Federal Fluminense
3 Cirurgião de Tórax do Grupo de Oncologia Torácica – Hospital do Câncer – HC I – INCA/MS. Título de Especialista pela SBCT / Thoracic Surgeon, Thoracic Oncology Group – Hospital do Câncer – HC I – INCA/MS. Specialist, SBCT
4 Patologista do Grupo de Oncologia Torácica – Hospital do Câncer – HC I – INCA/MS. Título de Especialista pela Sociedade Brasileira de Patologia / Pathologist, Thoracic Oncology Group – Hospital do Câncer HC I – INCA/MS. Specialist, Sociedade Brasileira de Patologia
5 Cirurgião de Tórax do Grupo de Oncologia Torácica – Hospital do Câncer – HC I – INCA/MS. Chefe do Serviço de Cirurgia Torácica do HC I – INCA/MS Título de Especialista pela SBCT. Doutor em Cirurgia Torácica pela Universidade Federal Fluminense / Thoracic Surgeon, Thoracic Oncology Group – Hospital do Câncer – HC I – INCA/MS. Director, Thoracic Surgery Unit, HC I – INCA/MS Specialist, SBCT. Thoracic Surgeon Universidade Federal Fluminense
6 Pneumologista do Grupo de Oncologia Torácica – Hospital do Câncer – HC I – INCA/MS Título de Especialista pela SBPT/AMB. Mestre em Pneumologia pela Universidade Federal Fluminense. Fellow American College of Chest Physicians / Pulmonologist, Thoracic Oncology Group – Hospital do Câncer – HC I – INCA/MS Specialist, SBPT/AMB. MSc in Pulmonology, Universidade Federal Fluminense. Fellow American College of Chest Physicians
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Título de Especialista pela SBCT. Mestre em Cirurgia Torácica pela Universidade Federal Fluminense / Thoracic Surgeon, Thoracic Oncology Group – Hospital do Câncer – HC I – INCA/MS. Specialist, SBCT. MSc in Thoracic Surgery, Universidade Federal Fluminense" "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Cirurgião de Tórax do Grupo de Oncologia Torácica – Hospital do Câncer – HC I – INCA/MS. Título de Especialista pela SBCT / Thoracic Surgeon, Thoracic Oncology Group – Hospital do Câncer – HC I – INCA/MS. Specialist, SBCT" "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Patologista do Grupo de Oncologia Torácica – Hospital do Câncer – HC I – INCA/MS. Título de Especialista pela Sociedade Brasileira de Patologia / Pathologist, Thoracic Oncology Group – Hospital do Câncer HC I – INCA/MS. 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Fellow American College of Chest Physicians / Pulmonologist, Thoracic Oncology Group – Hospital do Câncer – HC I – INCA/MS Specialist, SBPT/AMB. MSc in Pulmonology, Universidade Federal Fluminense. Fellow American College of Chest Physicians" "etiqueta" => "<span class="elsevierStyleSup">6</span>" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondence to/Correspondência: Rua Sorocaba 464/302. CEP 22271-110 Botafogo – Rio de Janeiro (RJ) – Brasil." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Punção aspirativa transbrônquica por agulha de linfonodos hilares e mediastinais" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-07-04" "fechaAceptado" => "2007-03-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec159212" "palabras" => array:6 [ 0 => "Lung cancer" 1 => "cytology" 2 => "staging" 3 => "flexible bronchoscopy" 4 => "lymph node metastases" 5 => "transbronchial needle aspiration" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec159213" "palabras" => array:6 [ 0 => "Carcinoma brônquico" 1 => "citologia" 2 => "estadiamento" 3 => "broncofibroscopia" 4 => "metástases linfonodais" 5 => "punção aspirativa transbrônquica com agulha" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Besides clarifying the etiology of unidentified lymphadenomegaly, puncturing hilar and mediastinal lymph nodes by a flexible bronchoscopic needle is an aid in diagnosing and staging bronchogenic cancer or other metastatic cancers.</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Our study had the principal objective to evaluate the positivity of transbronchial needle aspiration (TBNA).</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We evaluated retrospectively the effectiveness of all TBNA done in 74 consecutive patients. Forty-nine patients were male and the median age was 59. We used Wang-needles, 21-gauge (Bard, USA), and the same technique described for differents authors. Of the 74 patients evaluated, 11(15%) showed mediastinal mass and 65 (85%) hilar mass. We observed 76 endoscopics abnormalities.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">According to the classification of the specimens, we had 32/74 (43%) unsatisfactory specimens, 34/74 (46%) satisfactory and diagnostic specimens, and 8/74(11%) satisfactory and non-diagnostic specimens. Thirty four (46%) of the examinations were found to be positive out of the total amount of specimens. Of the positive results, 30/34 specimens (88%) contained malignant disease. Small-cell carcinoma was the most frequent finding, with 10/34 cases (29%); squamous cell carcinoma 7/34 (21%); adenocarcinoma 7/34 (21%), non--small cell carcinoma 6/34 (17%); sarcoidosis 2/34 (6%) and tuberculosis 2/34 (6%).</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Our study indicated that this method is safe, easy to perform, with a minimum of complications and useful for the diagnosis and staging of pulmonary neoplasms.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span class="elsevierStyleSectionTitle">Introdução</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A punção com agulha através da broncofibroscopia (TBNA), além de ser útil no esclarecimento das linfodenomegalias hilares e mediastinais, é também de utilidade no diagnóstico e estadiamento do carcinoma brônquico e de outras neoplasias metastáticas.</p> <span class="elsevierStyleSectionTitle">Objectivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Avaliar restrospectivamente a eficácia das TBNA realizadas em 74 doentes consecutivos. Quarenta e nove deles do sexo masculino e com idade mediana de 49 anos. Utilizámos a agulha de Wang, 21--gauge (Bard, USA), e a técnica utilizada foi a descrita pelos diversos autores. Dos 74 doentes estudados, 11 (15%) tinham linfadenomegalia mediastinal e 65 (85%) hilar. Observámos 72 anormalidades endoscópicas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De acordo com a classificação do material obtido, tivemos 32/74 (43%) cujo material foi insatisfatório para o diagnóstico; em 34/74 (46%), o material foi satisfatório e capaz de definir o diagnóstico; e 8/74 (11%) nos quais o material obtido foi satisfatório mas insuficiente para se definir o diagnóstico. Da amostra, 34 (46%) foram positivos. Destes, 30/34 (88%) eram doenças malignas. O carcinoma indiferenciado de pequenas células foi o mais comummente encontrado, com 10/34 (29%); o carcinoma escamoso, 7/34 (21%); o adenocarcinoma, 7/34 (21%); e o carcinoma de não pequenas células, 6/34 (17%). A sarcoidose foi identificada em 2/34 (6%) e a tuberculose em 2/34 (6%).</p> <span class="elsevierStyleSectionTitle">Conclusão</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O método é seguro, de fácil realização, com pequeno índice de complicações e de utilidade para o diagnóstico e estadiamento do cancro do pulmão.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "E. 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