Transbronchial needle aspiration for cytology specimens.

Transbronchial needle aspiration (TBNA) for diagnosis and staging of bronchogenic carcinoma has evolved in the USA since the late 1970's. Initial reports advised that aspirated specimens be flushed into a container by normal saline or Hank's solution and processed in a cytology laboratory usually by Millipore filter and other techniques. A highly sophisticated cytology laboratory is the key to the success of this procedure. This study was designed to assess a simpler alternative method of processing the specimen by a direct smear technique. From June 1990 to September 1990, 40 procedures were performed on 34 consecutive patients. Seventy two paired direct smear and fluid specimens for cytology examination were collected. Fifty specimens were found to be negative in both types of specimen preparation. Fifteen were found to be positive in both types of specimens preparation, and six specimens were found to be positive only in the direct smear preparation. One of the 72 specimens was found to be positive in the Millipore and other preparation techniques. Based on our data, we conclude that the use of the direct smear for TBNA specimen preparation is an effective, simpler, and improved method. Proper use of it may increase the diagnostic yield and result in better acceptance of this new procedure.