Objective: Transthoracic needle aspiration biopsies (TNAB) are ideal for diagnosis of peripheral lung nodules. The purpose of the study is to investigate computerized tomography (CT) guided TNAB at Landspitali University Hospital (LUH) in regard to indications, complications, results and evaluate the diagnoses that were obtained with the biopsies.
Material and methods: Retrospective study where information was obtained from clinical charts at LUH. A list of TNAB done over an 18 month period in 2003 to 2004 was obtained from the Department of Medical Imaging. Indications for biopsy, pathology diagnosis, complications and treatment were studied. Further studies and final diagnosis were also studied.
Results: There were total of 93 patients that had TNAB. Records were available on 82 patients (46 males og 36 females). Most often the study was done because of cancer suspicion. Nodules were commonly 2-3 cm large. Most commonly there was one nodule that was peripheral. 25/82 (30%) patients developed pneumothorax after the procedure and four patients needed a chest tube. The most common diagnosis was cancer in 36/82 (44%), unspecific changes in 15/82, normal tissue in 12/82, inflammation in 9/82 and other benign causes in 10/82. The sensitivity to diagnose cancer was 61% and specificity 100%. The final diagnosis was cancer in 59/82 (72%) of the cases and benign causes in 23/82.
Conclusions: The diagnostic yield of TNAB is lower in our study than in many previous studies. The rate of complications is similar. It it necessary to do followup studies in benign diagnoses because many of them have cancer when studied further.