title: CT-guided transthoracic fine needle aspiration of pulmonary lesions: accuracy and complications in 134 cases.
abstract: The aim of this study was to perform a prospective evaluation of the effectiveness of computed tomography (CT)-guided transthoracic fine needle aspiration (TFNA) in the diagnosis of pulmonary lesions and to determine the complication rate of this procedure. A prospective review was conducted of 134 patients who underwent CT-guided TFNA at our center between December 2003 and August 2005. All fine needle aspirations were performed with a 22-gauge single-pass Chiba needle under CT guidance. The biopsies were performed by one pulmonologist. Two hundred twenty two (91%) malignant lesions and 12 (9%) benign lesions were reviewed in the present study. An accurate diagnosis was made in 107 (88%) of the 122 malignant lung lesions and a specific diagnosis was obtained in 42% of the benign lesions. The sensitivity of TFNAs for the detection of malignancy was 83%, and the overall accuracy of TFNA for diagnosing malignancy was 84%. Pneumothorax occurred in 22 of the 134 patients (16%). Pneumothorax was more frequently observed in centrally located lesions (p= 0.001). Our results suggest that CT-guided TFNA has a high diagnostic accuracy and an acceptable rate of complications. Moreover, we suggest that the most important factor increasing the risk of pneumothorax is an increase in the depth of aerated lung traversed for sampling.
authors.affiliation: Clinic of Chest Diseases, Sureyyapaşa Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey. tbuskul@yahoo.com
authors.forename: Bahadir Taha
authors.initials: BT
authors.lastname: Uskül
authors.forename: Hatice
authors.initials: H
authors.lastname: Türker
authors.forename: Mertol
authors.initials: M
authors.lastname: Gökçe
authors.forename: Aydin
authors.initials: A
authors.lastname: Kant
authors.forename: Sinan
authors.initials: S
authors.lastname: Arslan
authors.forename: Fatma Emre
authors.initials: FE
authors.lastname: Turan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000175:diagnosis / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D055815:Young Adult