title: Percutaneous needle biopsy of mediastinal masses using a computed tomography-guided extrapleural approach.
abstract: This study was conducted to determine the reliability of mediastinal biopsy using a computed tomography-guided extrapleural approach. Twenty patients (16 men and 4 women) between the ages of 30 to 79 years underwent 22 percutaneous biopsies. The sampled masses ranged in size from 1.6 to 8 cm. A coaxial 17-gauge needle system was advanced into the fascia subjacent to the parietal pleura. An extrapleural fluid collection was created using a 20%/80% ratio of 1% lidocaine and normal saline. The blunt cannula was then advanced through the fluid to the edge of the lesion, and core or cytologic specimens were obtained. A diagnosis was obtained in 18 of 20 patients (90%). There were 10 malignant and 8 benign diagnoses. Complications included pneumothorax (1), vasovagal reactions (1), intercostal neuritis (1), and transient Homer's syndrome (1). In this series, both a high diagnostic yield as well as a low complication rate were obtained.
authors.affiliation: Department of Radiology, Weiss Memorial Hospital/The University of Chicago Hospitals, Illinois 60640, USA.
authors.forename: T H
authors.initials: TH
authors.lastname: Grant
authors.forename: M A
authors.initials: MA
authors.lastname: Stull
authors.forename: K
authors.initials: K
authors.lastname: Kandallu
authors.forename: J F
authors.initials: JF
authors.lastname: Chambliss
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed