Aims and objectives
To evaluate our 5 last years results of transthoracic core needle biopsy (TTNB) for lung lesions and usefulness of the rebiopsy of lung lesions (repeat TTNB) when it had a bening non tumoral results.
Methods and materials
Population
Six hundred and two cases of the Hospital Universitario Marqués de Valdecilla (Santander,
Spain) chest database were used to retrospectively select all TTNB performed in patients over the last 5 years of age between May 1,
2012,
and April 31,
2017.
The selected TTNB specimens were classified as follows: “malignant disease” for cases of histologically proven malignancy; “nonmalignant disease” for those with an identified but nonmalignant disease; and “without malignancy(negative) result” for those with no disease diagnosed.
Malignant results were not further investigated.
The...
Results
Of the 602 TTNB cases,
465 cases (77,2%) yielded tumors and 137 cases yielded non-tumorous lesions: 83 (60,6%) with an unexpected pathologic results and 54 (39,4%) with a benign result.
The repeat TTNB rate was 51,9% (28/54),
and the causes for a repeat TTNB in this type of lesions were clinical and radiological findings.
The results of the first biopsies are in the Fig. 2
Of the 28 cases with a second TTNB,
21 (75%) cases yielded different pathologic results on repeat TTNB from initial...
Conclusion
TTNB was useful for the diagnosis of pulmonary lesions.
Repeat TTNB might be helpful for the exact diagnosis of lung lesions where initial TTNB yields bening nontumoral results.
In 75% of the bening nontumoral TTNB specimen results were falsely negative for malignant diagnosis.
We think its necessary to do a second biopsy in patients with a nontumoral results in their first biopsy,
specially when they were necrosis or fibrosis.
Findings in a second TTNB at the same lesion can provided a final diagnosis in most...
References
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Mehta AC,
Wahidi MM.
Establishing the diagnosis of lung cancer: diagnosis and management of lung cancer,
3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.
Chest 2013; 143: e142S - e165S.
2 Clara Fontaine-Delaruelle; Pierre-Jean Souquet; Delphine Gamondes; Eric Pradat; Aurélie De Leusse ; Gilbert R.
Ferretti; and Sébastien Couraud.
Negative Predictive Value of Transthoracic Core-Needle Biopsy.
A Multicenter Study
Chest 2015: 148: 472-80
3 Montaudon M,
Latrabe V,
Pariente A,
Corneloup O,
Begueret H,
Laurent F.
Factors influencing accuracy...