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. 1992 Jun;47(6):457–460. doi: 10.1136/thx.47.6.457

Ultrasound guided percutaneous cutting biopsy for the diagnosis of pulmonary consolidations of unknown aetiology.

P C Yang 1, D B Chang 1, C J Yu 1, Y C Lee 1, S H Kuo 1, K T Luh 1
PMCID: PMC463812  PMID: 1496506

Abstract

BACKGROUND: Ultrasound has been used to guide percutaneous aspiration biopsy of thoracic tumours with high diagnostic yield. This study assessed the diagnostic value of ultrasound guided percutaneous cutting biopsy for pulmonary consolidation of unknown aetiology. METHODS: Thirty patients with undiagnosed lobar or segmental consolidation underwent ultrasound guided percutaneous needle aspiration and large bore cutting biopsy. The needle aspirates and biopsy specimens were sent for cytological, microbiological, and histopathological examination. RESULTS: Percutaneous needle aspiration provided a diagnosis in nine of 30 patients (30%), whereas cutting biopsy obtained a satisfactory specimen for histological diagnosis in 28 patients (93%) and provided a definite aetiological diagnosis in 17 patients (57%). The combination of needle aspiration with Trucut biopsy provided a diagnostic rate of 63%. The underlying diagnoses were fungal pneumonia (five patients), tuberculosis (five), bacterial pneumonia (one), bronchioloalveolar carcinoma (three), lymphoma (two), adenocarcinoma (one), vasculitis (one), acute pneumonia of unknown aetiology (one), and chronic non-specific pneumonia (nine). Two patients, who had necrotic tissue only in the biopsy specimen, were found at thoracotomy to have an adenocarcinoma and aspergillosis. Two patients had complications from the technique, a small pneumothorax in one and a small haemoptysis in another. CONCLUSIONS: Ultrasound guided percutaneous cutting biopsy is a valuable method for diagnosing pulmonary consolidation of unknown aetiology. The diagnostic yield is high and the procedure appears to be relatively safe.

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Selected References

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  1. Bandt P. D., Blank N., Castellino R. A. Needle diagnosis of pneumonitis. Value in high-risk patients. JAMA. 1972 Jun 19;220(12):1578–1580. [PubMed] [Google Scholar]
  2. Chaudhary S., Hughes W. T., Feldman S., Sanyal S. K., Coburn T., Ossi M., Cox F. Percutaneous transthoracic needle aspiration of the lung. Diagnosing Pneumocystis carinii pneumonitis. Am J Dis Child. 1977 Aug;131(8):902–907. doi: 10.1001/archpedi.1977.02120210080017. [DOI] [PubMed] [Google Scholar]
  3. Cunningham J. H., Zavala D. C., Corry R. J., Keim L. W. Trephine air drill, bronchial brush, and fiberoptic transbronchial lung biopsies in immunosuppressed patients. Am Rev Respir Dis. 1977 Feb;115(2):213–220. doi: 10.1164/arrd.1977.115.2.213. [DOI] [PubMed] [Google Scholar]
  4. Gherman C. R., Simon H. J. Pneumonia complicating severe underlying disease. A current appraisal of transthoracic lung puncture. Dis Chest. 1965 Sep;48(3):297–304. doi: 10.1378/chest.48.3.297. [DOI] [PubMed] [Google Scholar]
  5. Greenman R. L., Goodall P. T., King D. Lung biopsy in immunocompromised hosts. Am J Med. 1975 Oct;59(4):488–496. doi: 10.1016/0002-9343(75)90256-9. [DOI] [PubMed] [Google Scholar]
  6. Izumi S., Tamaki S., Natori H., Kira S. Ultrasonically guided aspiration needle biopsy in disease of the chest. Am Rev Respir Dis. 1982 Apr;125(4):460–464. doi: 10.1164/arrd.1982.125.4.460. [DOI] [PubMed] [Google Scholar]
  7. Palmer D. L., Davidson M., Lusk R. Needle aspiration of the lung in complex pneumonias. Chest. 1980 Jul;78(1):16–21. doi: 10.1378/chest.78.1.16. [DOI] [PubMed] [Google Scholar]
  8. Poe R. H., Utell M. J., Israel R. H., Hall W. J., Eshleman J. D. Sensitivity and specificity of the nonspecific transbronchial lung biopsy. Am Rev Respir Dis. 1979 Jan;119(1):25–31. doi: 10.1164/arrd.1979.119.1.25. [DOI] [PubMed] [Google Scholar]
  9. Stevens G. M., Weigen J. F., Lillington G. A. Needle aspiration biopsy of localized pulmonary lesions with amplified fluoroscopic guidance. Am J Roentgenol Radium Ther Nucl Med. 1968 Jul;103(3):561–571. doi: 10.2214/ajr.103.3.561. [DOI] [PubMed] [Google Scholar]
  10. Torres A., Jiménez P., Puig de la Bellacasa J., Celis R., González J., Gea J. Diagnostic value of nonfluoroscopic percutaneous lung needle aspiration in patients with pneumonia. Chest. 1990 Oct;98(4):840–844. doi: 10.1378/chest.98.4.840. [DOI] [PubMed] [Google Scholar]
  11. Yang P. C., Lee L. N., Luh K. T., Kuo S. H., Yang S. P. Ultrasonography of Pancoast tumor. Chest. 1988 Jul;94(1):124–128. doi: 10.1378/chest.94.1.124. [DOI] [PubMed] [Google Scholar]
  12. Yang P. C., Luh K. T., Sheu J. C., Kuo S. H., Yang S. P. Peripheral pulmonary lesions: ultrasonography and ultrasonically guided aspiration biopsy. Radiology. 1985 May;155(2):451–456. doi: 10.1148/radiology.155.2.3885310. [DOI] [PubMed] [Google Scholar]
  13. Yang P. C., Luh K. T., Wu H. D., Chang D. B., Lee L. N., Kuo S. H., Yang S. P. Lung tumors associated with obstructive pneumonitis: US studies. Radiology. 1990 Mar;174(3 Pt 1):717–720. doi: 10.1148/radiology.174.3.2406780. [DOI] [PubMed] [Google Scholar]
  14. Yu C. J., Yang P. C., Chang D. B., Wu H. D., Lee L. N., Lee Y. C., Kuo S. H., Luh K. T. Evaluation of ultrasonically guided biopsies of mediastinal masses. Chest. 1991 Aug;100(2):399–405. doi: 10.1378/chest.100.2.399. [DOI] [PubMed] [Google Scholar]

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