Lung Biopsy Procedures Research Articles

Wound infection caused by Branhamella catarrhalis

Branhamella catarrhalis was isolated from sputum, tracheal secretions, and a nonhealing and infected thoracic surgical wound in a 59-year-old woman who had a history of a chronic, interstitial fibrosis and who had undergone an open lung biopsy procedure. The patient's upper respiratory tract was the likely source of the organism. To our knowledge, this is the first report of a wound infection caused by B. catarrhalis.

Do radiologists control imaging studies? Survey results from 198 academic institutions.

Survey data were collected in 1987 from 198 academic radiology departments in North America to determine the degree to which radiologists are responsible for 32 imaging or imaging-related interventional procedures. The 32 were chosen because they were thought to be potential sources of conflict with nonradiology clinicians. The data reveal that academic radiologists either totally control or strongly dominate bone and breast radiography, percutaneous lung biopsy, percutaneous genitourinary and biliary tract interventional procedures, abscess drainages guided with computed tomography (CT) or ultrasound (US), both peripheral and renal angioplasty, pulmonary angiography, all of neuroradiology, all of CT, and all of magnetic resonance imaging. Radiologists have a dominant role in obstetric US, percutaneous inferior vena cava filter placement, and urethrography, although there is significant participation by nonradiologists in these studies. Radiologists and nonradiologists have roughly equivalent roles in vascular US and hysterosalpingography. Nonradiologists have the dominant roles in percutaneous gastrostomy, endoscopic retrograde cholangiopancreatography, kidney stone lithotripsy, coronary angiography and angioplasty, pediatric angiocardiography, and echocardiography.

Fibreoptic bronchoscopy in diagnosis of bronchopulmonary Kaposi's sarcoma.

Kaposi's sarcoma of the lung patients with the acquired immune deficiency syndrome is often indistinguishable by clinical and radiographic criteria from opportunistic pneumonia. Pulmonary Kaposi's sarcoma and pneumonia may frequently be present in the same patient. Previous observers have commented on the repeated failure to establish a diagnosis of Kaposi's sarcoma of the lung by fibreoptic bronchoscopy. Thirteen fibreoptic bronchoscopies were performed in a series of 11 patients with thoracic manifestations of AIDS and Kaposi's sarcoma was identified in transbronchial or bronchial biopsy specimens in four patients. This diagnostic yield is comparable to that obtained only by open lung biopsy procedures in previous reports. Fibreoptic bronchoscopy may contribute to the correct management of the patient and facilitate an accurate prognosis by differentiating between opportunistic pneumonia and pulmonary Kaposi's sarcoma.

A specially designed cutting aspiration needle for lung biopsy

The results of 166 lung biopsy procedures performed on 151 patients using a specially designed cutting aspiration needle are summarized. Excellent tissue cores and fragments of tissue were obtained providing a pathologic diagnosis in 85.5% of attempts. A correspondingly low overall complication rate of 12.7% was obtained.

Pulmonary infiltrates and fever in patients with hematologic malignancy: Assessment of transbronchial biopsy

Pulmonary infiltrates associated with fever are frequently encountered in patients with acute leukemia or lymphoma. In this prospective series, we analyze 47 such episodes in 43 patients. Over-all mortality was 45 per cent in patients with infiltrates and somewhat higher when they also had neutropenia (55 per cent) or acute leukemia (67 per cent). Pulmonary infiltrates could be categorized into three roentgenographic patterns: local consolidation (55 per cent); cavitary disease (13 per cent) and diffuse interstitial disease (32 per cent). The exact etiology of the infiltrates could not be predicted by roentgenographic study. Microbiologic or histopathoiogic diagnosis was established during life in 57 per cent of the patients, with infection most commonly encountered. Twenty-one patients underwent lung biopsy procedures. Biopsy specimens were frequently diagnostic (n = 17) and often dictated therapeutic changes (n = 12). Transbronchial lung biopsy via the fiberoptic bronchoscope was utilized in 14 patients during the latter part of this study; diagnoses were obtained in nine patients. Morbidity was minimal with this procedure, and the need for thoracotomy was diminished when it was available.

Lung biopsy in immunocompromised hosts

Ninety-five lung biopsy procedures in 78 immunocompromised patients yielded treatable diagnoses in 35 per cent of the needle aspirates, 46 per cent of the cutting needle biopsies and 65 per cent of the open thoracotomies. Complication rates of bleeding or pneumothorax were comparable to those previously described in nonimmunocompromised patients. In patients with coagulation defects, the risk of having bleeding complications was high. Among 44 patients with primary lymphoma, 22 (50 per cent) had a lymphomatous infiltrate in the lung. Twenty-two patients with severe hypoxemia were studied and their mortality, although significantly greater than that in the patients without hypoxemia, was marginally improved when a treatable lung lesion was found. The over-all recovery rate was 70 per cent when a treatable diagnosis was made in contrast to 25 per cent when there was no specific diagnosis. Hence lung biopsy, particularly by thoracotomy, appears to be a valuable procedure in immunocompromised patients who have otherwise undiagnosable lung lesions.