Chest
Clinical InvestigationsNeedle Aspiration Biopsy of Malignant Lung Masses With Necrotic Centers: Improved Sensitivity With Ultrasonic Guidance
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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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Manuscript received April 30; revision accepted September 15.