title: Ultrasound-guided fine needle aspiration biopsy of small pulmonary nodules abutting to the chest wall.
abstract: BACKGROUND
  Ultrasound (US)-guided needle biopsies in peripheral pulmonary lesions are widely applied. Most pulmonary lesions had a large size. We report our results in evaluating the availability of US-guided fine needle aspiration biopsy (US-guided FNAB) in diagnosing small pulmonary nodules abutting to the chest wall.
  
  
  METHODS
  Forty patients, whose chest radiographs showed peripheral pulmonary nodules of diameter smaller than 3.0cm, received chest sonographic examination and US-guided FNAB. Of those, six patients had no definite diagnoses; the remaining 34 patients with pulmonary nodules, we divided into three groups. There were four tiny nodules of diameters smaller than 1.0cm, 11 nodules between 1.1 and 2.0cm, and 19 nodules between 2.1 and 3.0cm. We evaluated the diagnostic yields and rates of complication in relation to the size or nature of the nodule.
  
  
  RESULTS
  In the enrolled 40 patients, six were lost to surveillance and had indeterminate diagnoses. Of the remaining 34 patients with proven pathological diagnoses and compatible clinical conditions, the diagnostic yields of US-guided FNAB achieved 88% (30/34) which include 96% (26/27) in malignancies and 57% (4/7) in benign nodules. According to the nodular size, the diagnostic rate achieved 100% (4/4) in tiny nodules, 91% (10/11) in nodules between 1.1 and 2.0cm, and 84% (16/19) in nodules between 2.1 and 3.0cm. Only one patient with a 2.5-cm nodule developed pneumothorax after the US-guided FNAB procedure.
  
  
  CONCLUSIONS
  US-guided FNAB is a useful and safe diagnostic tool for small pulmonary nodules abutting to the chest wall. The nodular nature, but not size, affects the diagnostic yields and rates of complication.
authors.affiliation: Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan, R.O.C.
authors.forename: C C
authors.initials: CC
authors.lastname: Chen
authors.forename: W H
authors.initials: WH
authors.lastname: Hsu
authors.forename: C M
authors.initials: CM
authors.lastname: Huang
authors.forename: J Y
authors.initials: JY
authors.lastname: Hsu
authors.forename: C D
authors.initials: CD
authors.lastname: Chiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D013909:Thorax; D014463:Ultrasonography