Computed tomography- guided percutaneous core needle biopsy for diagnosis of intathoracic mass lesions: experience at a tertiary care centre of North India

Background: CT guided core needle biopsy is a less invasive method for initial diagnostic workup in the assessment of intrathoracic masses. This study was conducted to evaluate the diagnostic yield of the procedure as well as to demonstrate the spectrum of various disease in our population.Methods: Present study was conducted in a tertiary care hospital for a study period of two years. Patients with intrathoracic mass were included and CT guided biopsies were performed following a protocol. The CT guided biopsies received were examined for histological diagnosis. Immunohistochemistry was carried out where ever routine histopathology was not sufficient for diagnosis. Relevant immunohistochemical panels were applied for lung, mediastinal and pleural tumours according to the histological differential diagnosis. Detailed demographic and clinical profiles along with radiological findings were noted.Results: Total of 138 cases were taken for CT guided FNAC procedure and 123 (89.1%) cases yielded diagnostic biopsy. Lung was the most commonly involved organ followed by mediastinum. Bronchogenic carcinoma was the most common lesion reported in lung and Non-Hodgkin Lymphoma was the most common mediastinal lesion. Lung collapse was most common radiological feature.Conclusions: CT guided percutaneous biopsy is a valuable diagnostic technique providing for early accurate diagnosis and being minimally invasive procedure. Care should be taken while tissue processing and section cutting of intrathoracic biopsies as the biopsies are small and tissue loss should be prevented so that sufficient material is available for immunohistochemistry.

Diagnostic Value of Ultrasonography or Sonography X-ray Guided Percutaneous Needle Biopsy for Pulmonary Mass / 中国医师杂志

Objective To assess accuracy and safety of ultrasonography guided or sonography X-ray guided percutaneous neddle biopsy(US-PCNB or CT-PCNB) for diagnosis of pulmonary masses.Methods Seventy one patients with radiographic evidences of pulmonary mass underwent US-PCNB or CT-PCNB.The diagnostic results of US-PCNB or CT-PCNB were confirmed by surgery or by follow-up examinations.Results The accuracy rate for diagnosis of pulmonary malignancy US-PCNB and CT-PCNB was 96 2% vs 94 7%.Complications occurred 3 87% vs 5 26%.Conclusions There was no statistically differences between US-PCNB and CT-PCNB.US-PCNB suitable for pulmonary tumors of around type.CT-PCNB suitable for pulmonary tumors of central type.

Pulmonary Cryptococcosis / 결핵

A previously healthy 59-year old male patient was admitted due to cough and abnormal chest x-ray. Cough started 5 months ago and persisted. Two months before admission, abnormality in chest PA was detected. He had no symptom other than cough. He was nonsmoker and physical examination revealed no abnormal finding. His chest X-ray showed ill-defined 2x1 cm ovoid infiltration in left middle lung field. On chest computed tomography, it was located in the subpleural region of posterobasal segment of left lower lobe. Mediastinal lymphadenopathy was absent. Blood test and sputum examination were not diagnostic. Fluoroscopy-guided percutaneous needle biopsy revealed pulmonary cryptococcosis. After central nervous system involvement was excluded by spinal tap, oral ketoconazole therapy was started. The lesion decreased in size after 8 weeks of therapy and almost disappeared on follow-up chest X-ray 4 months later.