Does percutaneous fine-needle aspiration biopsy aid in the diagnosis and surgical management of lung masses?
OBJECTIVE
To evaluate the ability of percutaneous, transthoracic fine-needle aspiration biopsy (FNAB) to correctly diagnose intrathoracic masses, to determine what complications were experienced and at what rate they occurred and to define more clearly the role of this technique in the surgical management of lung masses.


METHODS
A chart review.


METHODS
Kingston General Hospital, Kingston, Ont., a tertiary care centre and university-affiliated teaching hospital.


METHODS
One hundred and thirteen patients who underwent 117 percutaneous transthoracic FNABs between Jan. 1, 1991, and July 1, 1996.


METHODS
Patient demographics, size and location of the lesion, diagnostic result of FNAB, complications of the procedure, smoking history, number of needle passes made by the radiologist and results of any other available biopsy (i.e., through bronchoscopy, mediastinoscopy, pleuroscopy) and of surgical resection, as well clinical information pertaining to the disease state in patients with nondiagnostic or negative FNAB.


RESULTS
Eighty-six masses (73.5%) were diagnosed as malignant, 31 biopsy specimens (26.5%) were either nondiagnostic or negative for malignancy. Of these specimens, 15 (48.4%) were subsequently shown to be cancer. In 64 biopsies (54.7%), the patient suffered pneumothorax, requiring hospitalization and chest tube insertion in 35 (29.9%) and 24 (20.5%) cases respectively. The size of the lesion was related to both the diagnostic accuracy and the incidence of pneumothorax.


CONCLUSIONS
Percutaneous transthoracic FNAB should not be used routinely in the assessment of patients with lung masses who are medically fit to withstand surgery and are free of widespread disease. The results of FNAB do little to modify the course of surgical management in these patients.
Odell
M J
MJ
Division of Cardiothoracic Surgery, Department of Surgery, Queen's University, Kingston, Ont.
Reid
K R
KR
D000368:Aged; D001707:Biopsy, Needle; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies