Significance of the Presence of Lymphocytes in the Cytological Analysis of Transbronchial Needle Aspiration

Lucena, Carmen M.; Agustí, Carles; Martínez-Olondris, Pilar; Cano-Jiménez, Esteban; Marrades, Ramón M.; Ramírez, Josep; Sánchez, Marcelo; Arguis, Pedro; Xaubet, Antoni

doi:10.1016/S1579-2129(11)70030-1

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and basic research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

It is a monthly journal in which all manuscripts are sent to peer-review and handled by the editor or an associate editor from the team and the final decision is made on the basis of the comments from the expert reviewers and the editors. The journal is published solely in English. All the published data is composed of novel manuscripts not previously published in any other journal and not being in consideration for publication in any other journal..

The journal is indexed at Science Citation Index Expanded, Medline/Pubmed, Embase and SCOPUS. Access to any published article is possible through the journal's web page as well as from Pubmed, ScienceDirect, and other international databases. Furthermore, the journal is also present in X, Facebook and Linkedin. Manuscripts can be submitted electronically using the following web site: https://www.editorialmanager.com/ARBR/.

Indexed in:

Current Contents/Clinical Medicine, JCR SCI-Expanded, Index Medicus/Medline, Excerpta Medica/EMBASE, IBECS, IME, SCOPUS, IBECS

Subscribe:

Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2023

8.7

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

3.5

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.464

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

0.482

View more metrics

Open Access Option

Journal Information

Previous article | Next article

Vol. 47. Issue 3.

Pages 122-127 (January 2011)

More article options

Pages 122-127 (January 2011)

Original Article

DOI: 10.1016/S1579-2129(11)70030-1

Full text access

Significance of the Presence of Lymphocytes in the Cytological Analysis of Transbronchial Needle Aspiration

Significado de la presencia de linfocitos en el análisis citológico de la punción transbronquial aspirativa

Visits

4618

Download PDF

Carmen M. Lucenaa,

Corresponding author

cmlucena@clinic.ub.es

Corresponding author.

, Carles Agustía, Pilar Martínez-Olondrisa, Esteban Cano-Jiméneza, Ramón M. Marradesa, Josep Ramírezb, Marcelo Sánchezc, Pedro Arguisc, Antoni Xaubeta

a Servicio de Neumología, Instituto Clínico del Tórax, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes) 2009 SGR 911, Barcelona, Spain

b Servicio de Anatomía Patológica, Hospital Clínic, Barcelona, Spain

c Servicio de Radiodiagnóstico, Hospital Clínic, Barcelona, Spain

This item has received

4618 Visits

Article information

Statistics

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 with evidence of lymphocytes but no atypical cells.

Results

A total of 266 TBNA were performed in 252 patients with pathological mediastinal lymphadenopathy. One hundred and fifteen TBNA samples showed evidence of malignant cells (43%) and 94 (35%) samples were considered inadequate (absence of adequate cytological material or exclusive presence of bronchial epithelial cells). Out of the 57 TBNA samples remaining that contained lymphocytes without atypia (21%), 15 could not be confirmed. Thirty-two TBNA samples were confirmed with alternative diagnostic techniques and 10 were confirmed after clinical and radiological follow-up. The NPV of the 32 samples that were confirmed with alternative diagnostic techniques was 84%, which decreased to 76% when we included the 10 TBNA samples confirmed after clinical and radiological follow-up.

Conclusions

The presence of lymphocytes without atypia in TBNA samples does not rule out the neoplastic invasion of the lymph node analyzed.

Keywords:

Transbronchial needle aspiration

Lung cancer

Mediastinal lymphadenopathy

Resumen

Objetivo

Analizar el significado de la presencia de linfocitos en las muestras de punción transbronquial aspirativa (PTA) de adenopatías mediastínicas (AM) en pacientes con sospecha de cáncer de pulmón (CP).

Métodos

Estudio observacional retrospectivo que evalúa el valor predictivo negativo (VPN) de las muestras de PTA con evidencia de linfocitos pero sin células atípicas.

Resultados

Se realizaron 266 PTA a 252 pacientes con AM patológicas. En 115 PTA se evidenció la presencia de metástasis ganglionares (43%), y 94 (35%) fueron consideradas como no valorables (ausencia de material citológico evaluable o presencia exclusiva de células epiteliales bronquiales). De las 57 muestras de PTA restantes que contenían linfocitos sin atipias (21%), en 15 no se pudo confirmar el diagnóstico; en 32 se confirmó mediante técnicas diagnósticas alternativas y en 10 mediante seguimiento clínico-radiológico. El VPN de las 32 muestras confirmadas con técnicas diagnósticas alternativas fue del 84% y descendió al 76% cuando se incluyeron las 10 PTA en las que se disponía de seguimiento clínico-radiológico.

Conclusiones

La presencia de linfocitos sin atipias en la muestra de PTA no excluye la invasión neoplásica del ganglio analizado.

Palabras clave:

Punción transbronquial aspirativa

Cáncer de pulmón

Adenopatías mediastínicas

Full text is only aviable in PDF

References

[1.]

R. Ramí, J.L. Duque, J.R. Hernández, J. Sánchez de Cos, Grupo de trabajo SEPAR.

Normativa actualizada sobre diagnóstico y estadificación del carcinoma broncogénico.

Arch Bronconeumol, 34 (1998), pp. 437-452

Medline

[2.]

J.W. Lewis, J.L. Pearlberg, G.H. Beute, M. Alpern, P.A. Kvale, B.H. Gross, et al.

Can computed tomography of the Cheste stage lung cancer? Yes and no.

Ann Thorac Surg, 49 (1990), pp. 591-596

Medline

[3.]

M. Coughlin, J. Deslaurieres, M. Beaulieu, B. Fournier, M. Piraux, J. Rauleau, et al.

Role of mediastinoscopy in pretreatment staging of patients with primary lung cancer.

Ann Thorac Surg, 40 (1985), pp. 556-560

Medline

[4.]

R.J. Ginsberg.

Evaluation of the mediastinum by invasive techniques.

Surg Clin North Am, 67 (1987), pp. 1025-1035

Medline

[5.]

C. Agustí.

Mediastinoscopia: ¿una especie en peligro de extinción?.

Arch Bronconeumol, 43 (2007), pp. 475-476

Medline

[6.]

C. Disdier, F. Rodríguez de Castro.

Punción transbronquial aspirativa.

Arch Bronconeumol, 36 (2000), pp. 590-593

[7.]

A. Sharafkhanch, W. Baaklini, A. Gorin, L. Green.

Yield of transbronchial needle aspiration in diagnosis of mediastinal lesions.

Chest, 124 (2003), pp. 2131-2135

Medline

[8.]

E.M. Harrow, W. Abi-Saleh, J. Blum, T. Harkin, S. Gasparini, D.J. Addrizzo-Harris, et al.

The utility of transbronchial needle aspiration in the staging of bronchogenic carcinoma.

Am J Respir Crit Care Med, 161 (2000), pp. 601-607

http://dx.doi.org/10.1164/ajrccm.161.2.9902040 | Medline

[9.]

K. Katis, G. Kotrogiannis, I. Paraskevopoulos, X. Tsiafaki, J. Dahabreth, K. Blana, et al.

Bronchoscopic needle aspiration in mediastinal staging of patients with bronchogenic carcinoma.

J Bronchol, 5 (1998), pp. 195-199

[10.]

P.J. Utz, A.M. Paltel, E.S. Edells.

The role of transcarinal needle aspiration in the staging of bronchogenic carcinoma.

Chest, 104 (1993), pp. 1012-1016

Medline

[11.]

A. Fernández-Villar, F. Iglesias, M. Mosteiro, D. Corbacho, A. González, P. Blanco, et al.

Factores predoctores del resultado de la punción-aspiración transtraqueal de adenopatías mediastínicas neoplásicas.

Arch Bronconeumol, 41 (2005), pp. 434-438

Medline

[12.]

P. Martínez-Olondris, M. Molina, A. Xaubet, R.M. Marrades, P. Luburich, J. Ramirez, et al.

Punción transbronquial aspirativa en el estudio de las adenopatías mediastínicas: rentabilidad coste-beneficio.

Arch Bronconeumol, 44 (2008), pp. 290-294

Medline

[13.]

J.J. Baker, P.H. Solanki, D.A. Schenk, C. Van Pelt, I. Ramzy.

Transbronchial fine needle aspiration of the mediastinum. Importance of lymphocytes as an indicador of specimen adequacy.

Acta Cytol, 34 (1990), pp. 517-523

Article | Medline

[14.]

K.P. Wang.

Staging of bronchogenic carcinoma by bronchoscopy.

Chest, 106 (1994), pp. 588-593

Medline

[15.]

S. Gasparini, G.A. Silvestri.

Usefulness of transbronchial needle aspiration in evaluating patients with lung cancer.

Thorax, 60 (2005), pp. 890-891

http://dx.doi.org/10.1136/thx.2005.048728 | Medline

[16.]

J.-E.C. Holty, W.G. Kuschner, M.K. Gould.

Accuracy of transbronchial needle aspiration for mediastinal staging of non-small cell lung cancer: a meta-analysis.

Thorax, 60 (2005), pp. 949-955

http://dx.doi.org/10.1136/thx.2005.041525 | Medline

[17.]

E.M. Toloza, L. Harpole, F. Detterbeck, D.C. McCrory.

Invasive staging of non-small cell lung cancer: a review of the current evidence.

Chest, 123 (2003), pp. 157-166

[18.]

M. Patelli, A. Lazzari, V. Poletti, R. Trisolini, A. Cancellieri, N. Lacava, et al.

Role of fiberscopic transbronchial needle aspiration in the staging of N2 disease due to non-small lung cancer.

Ann Thorac Surg, 73 (2002), pp. 407-411

Medline

[19.]

C. Disdier, G. Varela, J. Sánchez de Cos, O. Bengoechea, M. Jiménez, J. Garín, et al.

Utilidad de la punción transbronquial y la mediastinoscopia en la estadificación ganglionar mediastínica del carcinoma broncogénico no microcítico. Estudio preliminar.

Arch Bronconeumol, 34 (1998), pp. 237-244

Medline

[20.]

A. Fernández-Villar, M. Botana, V. Leiro, A. González, C. Represas, A. Ruano-Raviña.

Validity and reliability of trnasbronchial needle aspiration for diagnosing mediastinal adenopathies.

BMC Pulmonay Medicine, 10 (2010), pp. 24

[21.]

M.C. Coello, J.D. Luketich, V.R. Litle, T.E. Godfrey.

Prognostic significance of micrometastasis in non-small cell lung cancer.

Clinical Lung Cancer, 5 (2004), pp. 214-225

http://dx.doi.org/10.3816/CLC.2004.n.002 | Medline

◊