Chest
Volume 66, Issue 2, August 1974, Pages 216-218
Journal home page for Chest

SELECTED REPORTS
Percutaneous Needle Biopsy of the Lung: Report of Two Fatal Complications

https://doi.org/10.1378/chest.66.2.216Get rights and content

Two fatalities following percutaneous rang biopsy are reported. Cause of death was sudden massive endobronchial hemorrhage. The use of a cutting type (Vim-Silverman or Franklin-Silverman) needle is condemned on the basis of (a) review of the other 11 fatalities reported in the literature and (b) morbidity, mortality, and diagnostic yield figures from reported series.

Section snippets

CASE REPORTS

Case 1 was a 51-year-old man admitted to Oteen Veterans Administration Hospital for evaluation of a chronic productive cough of three months’ duration and an abnormal chest x-ray film. He denied hemoptysis, but admitted to a 15-pound weight loss. He had smoked two packs of cigarettes per day for 40 years.

The patient was asthenic on physical examination without cyanosis or labored respiration. His vital signs were normal and he was afebrile. Breath sounds were decreased in the right upper chest

DISCUSSION

Three different techniques for percutaneous lung biopsy have evolved since its introduction in the early 1800's by Leyden10 in Germany and Menetrier11 in France.

The first technique utilizes a fine gauge aspirating needle and relies on cytologic interpretation of small amounts of tissue. It has been used extensively in Scandinavia and Canada with few serious complications. Dahlgren and Lind12 report more than 3000 biopsies with no fatalities. Limitations of this method include the inability to

REFERENCES (22)

  • MeyerJE et al.

    Fatal complications of percutaneous lung biopsy

    Radiology

    (1970)
  • Cited by (49)

    • An Overview of Percutaneous CT-Guided Lung Biopsies

      2018, Journal of Radiology Nursing
      Citation Excerpt :

      The procedure enjoyed an early period of success in the diagnosis of focal malignant, focal benign, and diffuse pulmonary disease (Youmans, de Groot, Marshall, Morettin, & Derrick, 1970; Zavala & Bedell, 1972). Unfortunately, series of reported fatalities during the 1960s and 1970s mainly because of pneumothorax and hemorrhage cast core biopsies into disfavor as compared with fine needle aspirate (Meyer, Ferrucci, & Janower, 1970; Norenberg, Claxton, & Takaro, 1974). CT-guided lung biopsies were first reported in the literature by Haaga and Alfidi (1976).

    • Fine needle aspiration of the solitary pulmonary nodule

      2002, Seminars in Thoracic and Cardiovascular Surgery
    • Semi-invasive and invasive procedures for the diagnosis and staging of lung cancer I: Percutaneous transthoracic needle biopsy

      2000, Radiologic Clinics of North America
      Citation Excerpt :

      Death caused by major hemorrhage results from tracheobronchial aspiration and asphyxia. Massive fatal hemoptysis is a rare complication, associated with the use of larger-caliber (18-gauge and greater) cutting needles.5,26,46,53,56 Massive hemoptysis is extremely rare with needles of 20-gauge and smaller.84

    View all citing articles on Scopus
    View full text