Percutaneous needle aspiration biopsy of the lung

https://doi.org/10.1016/0002-9610(68)90500-XGet rights and content

Abstract

Localized pulmonary disease can be safely and accurately diagnosed by means of percutaneous needle aspiration biopsy using image amplifier fluoroscopy for guidance of the needle. This is true whether the lesion is large or small, central or peripheral, or benign or malignant. It is usually performed on an outpatient basis in the x-ray department with local anesthesia being used so that little or no pain will be experienced by the patient. Simple 3 to 6 inch 18 gauge needles holding a stylet are used and the aspirant is sent to the laboratory for cytologic and bacteriologic examination.

The procedure is particularly useful for those surgeons using preoperative irradiation in bronchogenic carcinoma since it gives a higher diagnostic yield than any other test short of thoracotomy. Other indications for its use include medical contraindication to or patient refusal of thoracotomy; the presence of metastatic, bilateral, or inoperable disease; unresolved “pneumonia;” and any persistent indeterminate localized lesion which cannot be diagnosed by other means.

There were 192 biopsies performed on 100 lesions. Sixty-two of the lesions later proved to be malignant. In this latter group there was an 84 per cent rate of diagnostic accuracy using the needle biopsy technic. False-positive results occurred in 2 per cent and false-negative in 6 per cent. The latter were treated as indeterminate lesions and these patients were operated upon.

There were no deaths and no serious complications. Biopsy of 31 per cent of the lesions resulted in pneumothoraxes but in only 7 per cent was closed intercostal drainage required. Six per cent of the patients had brief mild hemoptyses but no alarming bleeding. There was no evidence of tumor dissemination along the needle tract, spread of infection, or air embolism.

References (27)

  • C.R. Woolf

    Applications of aspiration lung biopsy with a review of the literature

    Dis. Chest

    (1954)
  • G.M. Stevens et al.

    Needle aspiration biopsy of localized pulmonary lesions

    California Med.

    (1967)
  • H. Leyden

    Uber infectiose Pneumonie

    Deutsch med. Wschnschr.

    (1883)
  • P. Menetrier

    Cancer primitif du poumon

    Bull. Soc. anat. Paris

    (1886)
  • L.F. Craver et al.

    Aspiration biopsy of tumors of lung

    J. Thoracic Surg.

    (1939)
  • F.R. Dutra et al.

    Needle biopsy of the lung

    J.A.M.A.

    (1954)
  • C.C. Franseen

    Aspiration biopsy with a description of a new type of needle

    New England J. Med.

    (1941)
  • E.Y. Gledhill et al.

    Needle aspiration in the diagnosis of lung carcinoma; report of experience with 75 aspirations

    Am. J. Clin. Path.

    (1949)
  • H.E. Martin et al.

    Aspiration biopsy

    Surg. Gynec. & Obst.

    (1934)
  • H.E. Martin et al.

    Advantages and limitations of aspiration biopsy

    Am. J. Roentgenol.

    (1936)
  • F.L. Miller

    Percutaneous needle biopsy in clinically inoperable pulmonary tumors

    U. S. Armed Forces Med. J.

    (1960)
  • G.P. Rosemond et al.

    Value and limitations of aspiration biopsy of lung lesions

    Radiology

    (1949)
  • S.W. Sappington et al.

    Lung puncture in lobar pneumonia

    Am. J. M. Sci.

    (1936)
  • Cited by (13)

    View all citing articles on Scopus

    Presented at the Thirty-Ninth Annual Meeting of the Pacific Coast Surgical Association, Honolulu, Hawaii, February 18–22, 1968.

    1

    From the Departments of Thoracic Surgery, Radiology, and Medical Chest Diseases, Palo Alto Clinic and Stanford University School of Medicine, Palo Alto, California.

    View full text