Chest
Clinical InvestigationsNeedle Aspiration Biopsy of Malignant Lung Masses With Necrotic Centers: Improved Sensitivity With Ultrasonic Guidance
Section snippets
MATERIALS AND METHODS
From January 1990 to July 1991, 60 patients had peripheral lung masses that required ultrasound examination and ultrasound-guided needle aspiration biopsy in National Taiwan University Hospital. Of these 60 patients, 14 (23 percent) had a lung mass with a large central necrotic area as demonstrated by ultraound; they were included in this study. The criteria for patient selection were as follows: (1) mass abutting the visceral pleura; (2) mass with a large central necrotic area manifested as a
RESULTS
A total of 14 patients who had malignant lung mass with a large central necrosis as demonstrated by ultrasound underwent ultrasound-guided aspiration biopsy successfully from both the central portion and peripheral wall portion of the mass. Table 1 summarizes the age and sex of the patients, the mass sizes, wall thicknesses, diameters of the necrotic area, echo patterns of the central necrosis, and the final results of aspiration biopsies. The mass sizes ranged from 4×6 cm to 13 × 15 cm. Their
DISCUSSION
For over a century, after the first report of successful percutaneous needle aspiration in the diagnosis of lung carcinoma by Menetrier in 1886, the needle aspiration technique has been used to obtain tissue proof of lung neoplasms. This technique has been slow to gain widespread usage because of understandable concern regarding potential complications. More recently, because of widespread acceptance of cytologic diagnosis8, 9, 10, 11, 12 and improved radiologic technique permitting a biopsy
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2019, Canadian Association of Radiologists JournalLung, Pleura and Chest Wall
2011, Clinical UltrasoundRole of thoracic ultrasound in the assessment of pleural and pulmonary diseases
2008, Journal of UltrasoundCitation Excerpt :In critically ill patients, even massive effusions can often be drained within a reasonably short time with a low-flow, low-pressure aspirator with a small-gauge needle (20 G). Pleural lesions that can be evaluated with US-guided transthoracic biopsy include nodular thickening, which appears as hypoechoic micronodulation often combined with pleural line thickening; and pleural mesotheliomas, which appear as hyperechoic mixed lesions, often multiple forms, that are associated with serohematic effusions [45]. ( Benign pleural lesions, such as fibromas or lipomas, are rare.)
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2008, Journal of Medical UltrasoundContrast-enhanced ultrasound (CEUS) for the study of peripheral lung lesions: A preliminary study
2006, Ultrasound in Medicine and BiologyCitation Excerpt :US is less costly and it also eliminates the need to expose the patient to radiation. The accuracy of diagnoses based on US-guided transthoracic biopsy has been estimated at 91 to 96% (Liao 2000; Pan 1993; Yang 2000). The recently developed technique of contrast-enhanced US (CEUS) has been used to differentiate between benign and malignant liver tumors (Correas 2001; Isozaki 2003; Jakobsen 2001).
Can PET-CT predict diagnostic success in ultrasonography-guided transthoracic fine needle aspiration biopsies in lung cancers?
2020, PulmonologyCitation Excerpt :In all US-guided TFNAB procedures, after the hypoechoic mass lesion is detected using US, anechoic, irregular hypoechogenicities or areas observed as mixed echo-patterns in the lesion, if any, are assessed as necrotic foci. A biopsy procedure is performed by avoiding these areas.16 Patients with a fasting time of at least 8 h and a normal blood glucose level were included in the procedure.
Manuscript received April 30; revision accepted September 15.