Transtracheal needle aspiration

A series of 27 transtracheal needle aspiration biopsies performed on 25 patients were reviewed. A rigid bronchoscope and rigid needle were used. The biopsies were performed as staging procedures in patients with bronchogenic carcinoma, or to obtain diagnoses in patients with mediastinal adenopathy. A cytopathologist attended 11 biopsies and microscopically examined a direct smear to determine adequacy. Repeat biopsies were taken at the time if necessary. A diagnosis was obtained in 9/11 (81%) of these cases. Only 3/16 biopsies (18.8%) performed in the absence of a pathologist were diagnostic. All negative cases were subsequently found to have disease (2 sarcoidosis, 13 cancer) by other methods including mediastinoscopy in 5 cases. In the patient group sampled, the technique of rigid needle and rigid bronchoscope with a cytopathologist in attendance resulted in a much higher sensitivity for the test than has been previously reported.