Significance of the presence of lymphocytes in the cytological analysis of transbronchial needle aspiration

Arch Bronconeumol. 2011 Mar;47(3):122-7. doi: 10.1016/j.arbres.2010.10.005. Epub 2011 Feb 1.
[Article in English, Spanish]

Abstract

Aim: To evaluate the clinical relevance of the presence of lymphocytes in transbronchial needle aspiration (TBNA) samples from pathological mediastinal lymph nodes in patients with suspected lung cancer.

Methods: Retrospective observational study evaluating the negative predictive value (NPV) of TBNA samples containing lymphocytes but not malignant cells.

Results: A total of 266 TBNA were performed in 252 patients with pathological lymph nodes. One hundred and fifteen TBNA samples had evidence of malignant cells (43%), and 94 (35%) samples were considered as inadequate (absence of adequate cytological material or exclusive presence of bronchial epithelial cells). Out of the 57 TBNA samples remaining (21%), 15 could not be confirmed; in 32, TBNA samples were confirmed with alternative diagnostic techniques and in 10, they were confirmed after clinical and radiological follow-up. The NPV of the 32 samples that were confirmed with alternative diagnostic techniques was 84% decreasing down to 76% when the 10 TBNA samples confirmed after clinical and radiological follow-up were included.

Conclusions: The presence of lymphocytes in the TBNA sample does not exclude the neoplasic invasion of the specific lymph node analyzed.

Publication types

  • Validation Study

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / secondary
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / methods*
  • Bronchi
  • Bronchoscopy
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / secondary*
  • Carcinoma, Small Cell / diagnostic imaging
  • Carcinoma, Small Cell / secondary*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / secondary
  • Colonic Neoplasms / pathology
  • Female
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / pathology*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphatic Metastasis / pathology*
  • Lymphocyte Count*
  • Lymphocytes / pathology*
  • Male
  • Mediastinum
  • Melanoma / diagnostic imaging
  • Melanoma / secondary*
  • Middle Aged
  • Positron-Emission Tomography
  • Predictive Value of Tests
  • Retrospective Studies
  • Single-Blind Method
  • Skin Neoplasms / pathology