Computed-tomographic-guided biopsy of thoracic nodules: a revision of 583 lesions

Clin Ter. 2007 Nov-Dec;158(6):509-13.

Abstract

Objectives: In pulmonary lesions, when bronchial or trans-bronchial biopsy is negative, thoracic Fine-Needle Aspiration Biopsy (FNAB) allows to obtain a cytological or histological diagnosis. The purpose of the current study is to investigate the usefulness of CT-guided FNAB to define the nature of pulmonary or thoracic lesions.

Materials and methods: Between May 1995 and September 2005, 583 patients (453 males, 133 females), with thoracic lesions, without evident intrabronchial neoplasm, underwent CT-guided FNAB of thoracic nodules. FNAB was performed with 19-20-21 gauge needles, disposable soft tissue, automatic aspiration biopsy Menghini set, 10-15 cm long.

Results: In 292 patients (50%) lesions were < or = 3 cm diameter. Post biopsy pneumothorax occurred in 103 (18%) patients, with 29 patients requiring chest tube placement. Post biopsy haemoptysis occurred in 21 (4%) patients, but no patient required treatment for haemoptysis. There were 72 benign lesions (16 neoplasms) and 491 cancers (456 primary, 35 metastasis). Diagnostic accuracy was 93% and sensitivity for malignancy 93%.

Conclusions: FNAB has excellent diagnostic rates and is a suitable technique for diagnosing thoracic lesions.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Fine-Needle / adverse effects
  • Biopsy, Fine-Needle / methods*
  • Chest Tubes
  • Diagnosis, Differential
  • Female
  • Hemoptysis / etiology
  • Humans
  • Lung Diseases / diagnosis
  • Lung Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • Pneumothorax / etiology
  • Pneumothorax / therapy
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Solitary Pulmonary Nodule / diagnosis*
  • Tomography, X-Ray Computed*