Comparison of the Wang 19-gauge and 22-gauge needles in the mediastinal staging of lung cancer

D. A. Schenk, S. L. Chambers, S. Derdak, K. H. Komadina, J. S. Pickard, P. J. Strollo, R. E. Lewis, A. J. Patefield, J. H. Henderson, S. M. Tomski, C. F. Morales, J. L. Sterling, P. H. Solanki, J. Moore

Research output: Contribution to journalArticlepeer-review

156 Scopus citations


Transbronchial needle aspiration (TBNA) offers the unique opportunity to pathologically stage patients with lung cancer at the time of diagnostic bronchoscopy. The purpose of this study was to compare the staging sensitivities of the Wang 22-gauge and 19-gauge needles. We studied 64 patients with bronchogenic carcinoma and mediastinal adenopathy. Before bronchoscopy each patient underwent chest CT. Three to four aspirates were obtained with each needle from endotracheal sites adjacent to paratracheal lymphadenopathy. In 47 patients malignant mediastinal adenopathy was confirmed by the 19-gauge needle. A total of 29 patients had malignant 22- gauge needle aspirates. Of the 64 patients, 9 had benign, reactive mediastinal lymph nodes. There were 20 patients in whom only the 19-gauge needle demonstrated malignancy and 2 patients with malignant 22-gauge needle aspirates as the sole identifier of paratracheal malignancy. As a staging tool, the 19-gauge needle was significantly more sensitive than the 22-gauge needle, 85.5 versus 52.7% (p = 0.0001). Overall, in 49 of 55 patients (89.1%) with malignant mediastinal lymphadenopathy paratracheal tumor was confirmed by TBNA. The 19-gauge TBNA staging of the mediastinum is an effective, safe, and cost-saving alternative to surgical mediastinal exploration that can be performed during initial diagnostic bronchoscopy.

Original languageEnglish (US)
Pages (from-to)1251-1258
Number of pages8
JournalAmerican Review of Respiratory Disease
Issue number5
StatePublished - 1993
Externally publishedYes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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