The Annals of Thoracic Surgery, Vol 32, 154-161, Copyright © 1981 by The Society of Thoracic Surgeons
Aspiration needle biopsy of thoracic lesions
TR Todd, G Weisbrod, LC Tao, DE Sanders, NC Delarue, DW Chamberlain, R Ilves, FG Pearson, W Cass and JD Cooper
We reviewed our experience with 2,114 percutaneous aspiration needle
biopsies of intrathoracic lesions. Aspiration was performed for cytological
diagnosis employing biplane fluoroscopy and a 20 gauge needle, 0.9 mm in
outside diameter. A satisfactory specimen was obtained in 88% of biopsies,
and the chance of obtaining a correct diagnosis of a malignant lesion was
81.5%. The false positive rate was 2.3%, and the cytologists could always
distinguish between primary and secondary neoplasms. A false negative rare
of 13.6% (36 patients) resulted in only three delayed thoracotomies and two
instances of interval metastases discovered at mediastinoscopy. Cellular
specificity in primary tumors was not sufficiently accurate to affect
therapy. Pneumothoraces occurred frequently (31.9% of patients) but wee
generally small; 10.4% of patients required chest drainage. There were no
recorded instances of tumor implantation in needle tracts. We conclude that
a rapid and accurate diagnosis of intrathoracic pathology can be obtained
by this technique. It is associated with an acceptable morbidity and may
greatly expedite both patient care and investigation.
