Fine needle aspiration biopsy of pulmonary lesions: a 2-year experience in a district general hospital with a literature review.
During the 2 years of 1987 and 1988, 74 patients with suspected malignant lung lesions underwent fine needle aspiration biopsy at the Bradford Royal Infirmary. Using a 20Fr needle, sufficient specimen (smear and clot) was obtained in 70 (95%) patients for histological examination. The indications for the procedure were: failure to make a diagnosis at bronchoscopy and bronchial lavage in 32 (43%) patients, peripherally located lesion in 28 (38%) patients, poor anaesthetic risk in 20 (27%) patients, negative bronchoscopy and mediastinostomy in five (7%) patients and three (4%) patients refused operative intervention. There were no deaths and complications were few. Seven patients developed pneumothorax, three of whom required intercostal drainage. Transient haemorrhage as shown by haemoptysis occurred in one patient and one patient complained of pleuritic chest pain. Of the 60 patients with malignant disease eventually proven, 50 were diagnosed correctly. The overall sensitivity and specificity of the test were 81 and 100% respectively based on histological and/or clinical outcome of the lung lesion. The test was cost-effective, diagnostic yield was high and complications were few. The use of fine needle aspiration biopsy as part of the management policy in peripheral lung lesions is realistic in a district general hospital.
Saa-Gandi
F W
FW
Department of Surgery, General Hospital, Port-of-Spain, Trinidad.
Mearns
A J
AJ
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects / Q000191:economics / Q000592:standards*; D001999:Bronchoscopy; D004739:England / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed