CT-guided biopsy of nonresolving focal air space consolidation.
OBJECTIVE
To evaluate the diagnostic accuracy of percutaneous computed tomography (CT)-guided coaxial core needle biopsy in patients with nonresolving pulmonary focal air space consolidations and negative fiberoptic bronchoscopy results.


METHODS
From 1997 to 2005, 23 patients (11 woman, 12 men; age range, 45 to 81 y; mean age, 66 y) presenting with nonresolving pneumonia persisting more than 8 weeks (mean, 22 wk; range, 8 to 40 wk) with negative fiberscopic results, underwent coaxial percutaneous biopsy using an automated core needle (18-gauge) under CT guidance. Histologic and bacteriologic evaluations were obtained. The final diagnosis was confirmed by surgical pathology, culture results, or clinical follow-up.


RESULTS
Specimens adequate for histopathologic evaluations were obtained in 20 (87%) cases. Final diagnoses were lung cancer (n=15) and benign diseases (infectious pneumonia, 3; lipoid pneumonia, 1; Erdheim Chester disease: 1; and nonspecific chronic pneumonia, 3). Diagnostic yield of core needle biopsy was 78% (18 of 23). The sensitivity and specificity for malignancy were 87% and 100%, respectively. Immediate pneumothorax was present in 11 patients of cases, but only 2 patients required pleural drainage.


CONCLUSIONS
CT-guided lung biopsy using a core needle biopsy provides a high degree of diagnostic accuracy and allows specific characterization of nonresolving pulmonary focal air space consolidation.
Ferretti
Gilbert R
GR
Service Central de Radiologie et Imagerie Médicale, Grenoble, France. gferretti@chu-grenoble.fr
Jankowski
Adrien
A
Rodière
Mathieu
M
Brichon
Pierre Yves
PY
Brambilla
Christian
C
Lantuejoul
Sylvie
S
D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods / Q000592:standards; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards*