Application Value Of C-TBNA And EBUS-TBNA In Mediastinal Bronchial-derived Cysts

ObjectiveTo investigate the value of convention-transbronchial needle aspiration(C-TBNA)and Endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)in mediastinal bronchogenic cysts.MethodFrom May 2008 to December 2016,twenty-seven patients diagnosed mediastinal bronchogenic cysts were selected.Whose chest CT scan showed mediastinal lesions and C-TBNA or EBUS-TBNA examination confirmed mediastinal bronchogenic cysts.Result(1)In general,27 patients,14 males and 13 females,aged 29-71 years,mean(47 士15.2)years,9 cases of clinical symptoms showed cough,mainly dry cough;6 cases showed Chest tightness,chest pain;2 cases showed upper eyelid ptosis or eyelid heavy feeling,12 cases without obvious clinical symptoms,physical examination or other diseases when the diagnosis of pulmonary CT found mediastinal lesions.(2)There were 13 cases of c-tbna examination in patients with the diagnosis of mediastinal bronchogenic cyst.Six cases,3 cases of the lumen process,4 cases of the vena cava,and the extraction of the liquid with a liquid volume of 8.9±1.5 ml.In 14 patients,EBUS was examined by EBUS and the ultrasonography showed a homogenous anechoic signal,which was located in the first 8 cases of the vena cava,2 cases in the brontosis and 4 cases in the posterior process.1 patients who underwent EBUS examination were treated with the wall thickness of the cyst.The puncture needle failed to puncture the wall of the cyst.The liquid was drawn out and the liquid was extracted 29.1 ±7.5 ml.EBUS-TBNA extraction was significantly higher than C-TBNA(P<0.05).(3)During the follow-up,1 patient had cyst rupture,secondary pulmonary infection and right pleural effusion,followed by surgical treatment,and 1 case died of esophageal cancer.Of the 27 patients with TBNA puncture,there were 15 cases of cyst enlargement or no obvious reduction in follow-up operation,including 13 cases of C-TBNA and EBUS-TBNA 2 cases。(4)In the 27 cases of patients with mediastinal bronchogenic cysts,12 cases were combined with malignant diseases,and the C-TBNA or EBUS-TBNA were examined for the removal of secondary infection of the cyst,including 11 cases of malignant lymphoma and 1 case of esophageal cancer.Conclusion(1)C-TBNA and EBUS-TBNA technology have high diagnostic value for the mediastinal bronchogenic cysts,and the diagnostic positive rate is 100%.(2)EBUS can provide the typical ultrasonic image of the endobronchial source cyst as anechoic signal,ebus-tbna can complete the puncture in real time,and the liquid volume is significantly higher than that of C-TBNA.(3)Both C-TBNA and EBUS-TBNA technology have the risk of secondary infection and recurrence of cysts.(4)TBNA puncture is suitable for mediastinal bronchogenic cysts.First:it is necessary to exclude cysts to merge infection,hemorrhage,or merge tumors.Second:the cyst causes obvious airway pressure symptoms and is not suitable for surgical treatment;Third:the cyst does not cause obvious symptoms and decides whether to give TBNA puncture according to the changes of follow-up imaging.