Coaxial transthoracic fine-needle biopsy in patients with a history of malignant lymphoma.
Efficacy and safety of coaxial transthoracic fine-needle biopsy were evaluated in 54 patients with a history of malignant lymphoma and new chest lesions. Twenty-one patients had recurrent lymphoma. Correct diagnosis was made in 17 of the 21 patients (81%) after one biopsy. The sensitivity increased to 95% with repeat needle biopsy in three patients. Immunophenotyping (determining phenotype by means of immunologic examination) was essential for a definitive diagnosis of lymphoma in three patients. Non-lymphomatous malignancies were correctly diagnosed in 14 patients. An infectious organism was identified in 11 of 19 patients (58%) with benign lesions. Pneumothorax occurred in eight patients (15%), necessitating placement of a chest tube in two (4%). Mild hemoptysis was observed in four patients (7%). The authors conclude that coaxial transthoracic fine-needle biopsy in patients with a history of lymphoma is safe and accurate. The use of large cutting needles or surgical biopsy can be restricted to patients with false-negative findings at percutaneous biopsy and to patients in whom histologic transformation of lymphoma is suspected.
Wittich
G R
GR
Department of Radiology, Stanford University Medical Center, CA 94305.
Nowels
K W
KW
Korn
R L
RL
Walter
R M
RM
Lucas
D E
DE
Dake
M D
MD
Jeffrey
R B
RB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D016130:Immunophenotyping; D008223:Lymphoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D013899:Thoracic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed