Patient Zhang, female, 23 years old, studying abroad, was admitted to our hospital with “fever for more than 20 days”. The patient was treated abroad for more than 20 days in July 2011, but the result was not good, with persistent fever and daily temperature fluctuations above 40℃. Zhang Caijing, Department of Respiratory Medicine, Shandong Qianfo Mountain Hospital After admission, he was given anti-infection, expectorant and symptomatic treatment, and also actively improved auxiliary examinations. The patient’s chest CT showed multiple enlarged mediastinal lymph nodes. The largest one was located around the left lower pulmonary artery, with a diameter of about 2*3 cm. Because of the patient’s serious condition, our department immediately organized several chiefs to hold an intra-departmental consultation and considered “nodular disease? Lymphadenopathy? Lymphoma? Lymphatic tuberculosis?” The patient was admitted to the hospital the next day. To clarify the diagnosis, a transbronchoscopic needle aspiration biopsy (TBNA) was performed under local anesthesia in our respiratory lumpectomy room on the second day of admission. Needle aspiration biopsy of lymph nodes was performed at the enlarged lymph nodes, and the operation went smoothly. Half an hour after the operation, the cytology of needle aspiration biopsy showed “a large number of neutrophil granulocytes”, and the diagnosis was “lymphadenitis”, and “lymphoma, nodular disease and lymphatic tuberculosis” were excluded. He was given anti-infection and glucocorticoid treatment. After half a month of treatment, the chest CT showed that the lymph nodes had shrunk significantly and the symptoms disappeared, and the patient was discharged from the hospital.
Introduction of TBNA: TBNA is a new technology of interventional diagnosis and treatment newly developed by the Department of Respiratory Medicine of our hospital, which is currently carried out in only two hospitals in the province, namely Provincial Hospital and Qianfo Mountain Hospital. Compared with mediastinoscopy, it has the advantages of small trauma, no anesthesia and low cost. It has a high positive rate for external pressure type luminal stenosis and mediastinal lymph node enlargement caused by intrapulmonary occupational lesions. At present, the positive rate of this test in our hospital is over 90%, which has won the praise of our colleagues and many patients in the industry!