Abstract
Rationale: Percutaneous transthoracic biopsy under computed tomography (CT) guidance has been well accepted as a useful technique to obtain tissue for histologic diagnosis of thoracic lesions that are not readily accessible with bronchoscopy. On the other hand, in the chest, the role of ultrasonography (US) has been limited to evaluation for pleural effusion and guidance for thoracentesis, although its role in the diagnosis of pulmonary, pleural, and mediastinal masses has been emphasized.
Aims: To examine the utility and safety evaluation of ultrasonography guided transthoracic biopsy at our institution.
Methods: From May 1, 2011 to October 31, 2013, US-guided transthoracic biopsies were performed in 42 consecutive patients at our institution. CT imaging characteristics of mass, histologic diagnosis, and complications were recorded.
Results: The location of the 42 lesions included 27 lung parenchymal, two pleural, six chest wall, and seven mediastinal. The mean mass diameter was 65.5 mm. A histologic diagnosis was achieved in 39 (92.8%) of 42 patients, including 31 primary or secondary carcinoma (74%); five lung abscess (12%), one empyema (2%), two non-specific inflammatory change (5%). CT scan demonstrated homogeneous or heterogeneous low attenuation in 21 lesions. There were nine (21.4%) procedure-related complications: three pneumothoraces, three pleuritis, and one hypotension due to vasovagal reflex, one disseminated to subcutaneous tissue, and one death.
Conclusions: US-guided thoracic biopsy is a safe, easy and reliable method with a high diagnostic yield in thoracic lesions.
- © 2014 ERS