Aims and objectives
CT-guided Fine Needle Aspiration Biopsy (FNAB) of pulmonary nodules is nowadays a standardized procedure used to characterize pulmonary lesions[1-7].
In our experience we carried out CT-guided pulmonary FNAB with the extemporary evaluation by the pathologist.
This method seems to increase the efficacy and the safety of the procedure and,
in our experience,
is the fastest and cheapest way to obtain a diagnosis.
Methods and materials
In our study,
we retrospectively evaluated 89 patients who underwent CT-guided FNAB of pulmonary nodules between April 2016 and March 2017.
All procedures were performed using a 22 G Chiba-type needle (length 9-15 cm) in a sterile ambient,
previous cutaneous disinfection and patient free breath.
A pathologist was present in the CT room who performed an extemporary evaluation after the first sampling using the Rapid On Site Evaluation (ROSE) method in order to check the adequacy of the FNAB smears,
cellular quantity and to do...
Results
On 89 FNAB,
81 (91%) lesions were properly characterized,
in 5 cases (4%) the diagnosis of malignancy without typing was made and in only 3 cases (3%) the samples were inadequate also for a preliminary diagnosis because of complications occurred after the first sample; we always carried out a maximum of 2 punctures in patients without first passage complications.
PNX occurred in 14 (15%) cases in which 12 (13%) at first puncture and 2 (2%) after the second one.
There were 5 (5,6%) cases of...
Conclusion
CT-guided FNAB is a safe and accurate technique[9,12-17]; in our experience the immediate pathologist analysis seems to increase the security of the procedure,
reducing the number of punctures and accordingly the complications. Furthermore,
the presence of pathologist decreases the time for diagnosis and the procedure costs.
Personal information
Department of Advanced Biomedical Sciences,
University of Naples Federico II,
Naples,
Italy.
References
1.
Transthoracic Needle Aspiration Biopsy: Variables That Affect Risk of Pneumothorax
Joseph E.
Cox et al.
2.
Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: comparison of small and large pulmonary nodules
Li H,
Boiselle PM et al.
3.
CT-guided fine-needle aspirations for diagnosis of benign and malignant disease.
Harter LP et al.
4.
Percutaneous transthoracic needle aspiration: a review
Perlmutt LM et al.
5.
Lung lesions: cytologic diagnosis by fineneedle biopsy
Stanley JH et al.
6.
Percutaneous transthoracic needle...