Transthoracic needle aspiration biopsy following negative fiberoptic bronchoscopy in solitary pulmonary nodules.
To evaluate the utility of transthoracic needle aspiration biopsy (TTNAB) following negative fiberoptic bronchoscopy (FOB) in a patient with a solitary pulmonary nodule (SPN), we reviewed the records from 262 patients who had undergone TTNAB over an eight-year period. Fifty-eight patients had a SPN and met the criteria for inclusion in this series. Twenty-five of these (43 percent) were diagnosed by TTNAB; 24 had malignant lesions; one had M tuberculosis. Of the remaining 33 patients, 18 went on to definitive diagnostic procedures (surgery, repeat FOB or TTNAB). Nine of these patients had a malignancy. Fifteen patients were followed long-term; one was diagnosed with carcinoma two years after the initial work-up. Carcinoma was not found in any patient under 40 years of age. A benign lesion was diagnosed by TTNAB in only two patients. We conclude that TTNAB is a valuable procedure in the evaluation of patients with a SPN and negative FOB. While a negative FOB and TTNAB do not assure that the lesion is benign, a complex of variables influences the decision regarding thoracotomy vs careful follow-up.
Levine
M S
MS
Department of Medicine, University of California/San Diego School of Medicine.
Weiss
J M
JM
Harrell
J H
JH
Cameron
T J
TJ
Moser
K M
KM
D000328:Adult; D000368:Aged; D000465:Algorithms; D001707:Biopsy, Needle; D001999:Bronchoscopy; D005069:Evaluation Studies as Topic; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000209:etiology