Diagnosis of intrapulomary lesions by fine-needle biopsy and core-cut biopsy: Accuracy and safety

Ziele: To determine accuracy and safety of fine-needle biopsy (FNP) and core cut biopsy of thoracic lesions under computed tomographic guidance. Methode: One hundred-and-four patients with thoracic lesions underwent CT-guided FNP and core-cut biopsy. None of the patients had severe chronic obstructive pulmonary disease (COPD) or severe restrictive lung disease neither a coagolopathy. Four patients had known extrathoracic primary tumors. All biopsies were performed utilizing a 19 gauge introducer-needle in all patients. The patients had first FNP with a 22 gauge needle followed by core cut biopsy with a 20 gauge needle. Written informed consent was given in all patients. Ergebnis: Adequate specimens were obtained in 93/104 (89.4%) and 78/104 (75%) patients for histological and cytological examinations, respectively (as determined by pathologist and cytopathologist). Sensitiviy, specificity and accuracy for histology and cytology were 87.6%, 95.4%, 89.3% and 68.2%, 85%, 71.5%, respectively. 24/104 (23.1%) patients developed a small pneumothorax, three patients patients required a transthoracal chest catheter to evacuate the pneumothorax. 9/104 (8.6%) patients developed minor hemoptysis. None of them required any further specific treatment. Schlussfolgerung: Core cut biopsy is a more accurate diagnostic tool in evaluating thoracic lesions and its complication rate is acceptable.

Key words

lung biopsy - CT - complications - thoracic lesions