• Hiromi Aono, Hiroaki Okamoto, Hiroshi Kunikane, Akira Nagatomo, Koshiro Watanabe, and Atsushi Nagai.
• Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, and First Department of Medicine, Tokyo Women's Medical University, Japan. hiromia@sb3.so-net.ne.jp
• Respirology. 2006 Nov 1; 11 (6): 782-5.

Objective And BackgroundThe aim of this study was to improve the staging of lung cancer with or without lymphadenopathy on chest CT by using transbronchial aspiration cytology (TBAC).MethodsTBAC of the subcarinal lymph nodes was performed on 153 consecutive patients with lung cancer, with or without subcarinal lymphadenopathy on chest CT.ResultsThirty-four patients had enlargement of the subcarinal lymph nodes (>1 cm). Eighteen of these had TBAC confirmation of metastases. Another seven patients with no mediastinal involvement on CT were positive for metastases on TBAC. TBAC was the only way to confirm lung cancer in two patients. Therefore, routinely performed subcarinal TBAC contributed to an improved non-operative staging of the patients and diagnosis in 16% (25/153) of the patients with lung cancer. Forty-nine patients with NSCLC had surgical resection of the tumour. Surgical procedure revealed metastases to the subcarinal lymph nodes in three patients in whom the preoperative TBAC diagnosis was normal. No significant complications due to TBAC occurred in any of the patients.ConclusionTBAC of the subcarinal lymph nodes is a minimally invasive technique for staging of lung cancer and can provide useful information for the diagnosis of metastases to the subcarinal lymph nodes.

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