Mediastinal needle biopsy. A 15-year experience with 139 cases.
BACKGROUND
Radiologically guided needle biopsy and cytologic evaluation provide a reliable method of diagnosis for planning definitive therapy of patients with mediastinal lesions.


METHODS
In this retrospective study of one of the largest series from a single institution, 141 consecutive mediastinal needle biopsies from 139 patients were reviewed during a 15-year period.


RESULTS
Adequate material was obtained with a diagnosis achieved in 128 cases (92%). Of these, 33 cases (26%) had benign diagnoses; the remaining 95 (74%) had malignant diagnoses, including 81 carcinomas, 3 sarcomas, 8 lymphoproliferative lesions, 2 malignant germ cell tumors, and 1 malignant thymoma. All benign cases were diagnostically confirmed, and 94 of 95 malignant cases were classified correctly. The only discrepancy that occurred involved a malignant lymphoma diagnosed as a malignant germ cell tumor. Of the 13 inadequate samples, the major category included a nodular sclerosis variant of Hodgkin's disease (4 cases), 1 case of thymoma, 1 case of tuberculous lymphadenitis, and 7 cases for which no follow-up data were available.


CONCLUSIONS
Needle biopsy is reaffirmed as a reliable and sensitive diagnostic tool for mediastinal lesions, with an overall cytologic diagnostic accuracy of 99% with adequate material. Sclerotic lesions may pose a limitation to this technique and require generous sampling before a more invasive diagnostic procedure is undertaken.
Zafar
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N
Department of Pathology, University of Tennessee, Memphis, USA.
Moinuddin
S
S
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D003560:Cysts / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis*; D008875:Middle Aged; D012189:Retrospective Studies