Needle Biopsy In Patients Research Articles

Diagnostic accuracy and clinical impact of renal biopsy cytology.

The role of fine needle biopsy cytology in the workup of renal mass lesions remains controversial. With advances in imaging technology and clinical management for renal masses, a critical reevaluation of the role of renal biopsy is needed. This study was designed to provide a comprehensive evaluation of the performance and clinical impact of fine needle biopsy in patients with renal masses. A 5-year retrospective study of ultrasound or computer tomography (CT)-guided fine needle biopsies of renal masses diagnosed via cytopathology was conducted. Overall diagnostic rate, sensitivity, and diagnostic accuracy were calculated. Further analysis of the impact of fine needle biopsy cytology on clinical management was performed. A total of 227 cases of fine-needle aspiration and/or biopsy (FNA/B) of renal masses were identified, including 76 with subsequent nephrectomies. Complications were rare (<1%). The diagnostic rate and sensitivity of FNA/B were 83.3% and 89.5%, respectively. Diagnostic accuracy was 98.7% at the major categorical level and 94.7% at the tumor subtype level. Subsequent clinical actions were associated with a definitive cytologic diagnosis of malignancy/neoplasia (p < .05) and were affected by tumor subtype (p < .05). This study demonstrates that FNA/B of renal masses is a safe and reliable minimally invasive diagnostic tool with excellent accuracy in confirmation of malignancy and subclassification of tumors. Diagnoses made on FNA/B play a key role in guiding a personalized clinical treatment plan.

A Comprehensive Assessment of Radial Scars on Core Needle Biopsy in Patients with or without Breast Cancer: Upgrade Rate and Implications on Management

BackgroundRadial scars/radial sclerosing lesions (RS) are benign breast lesions identified on core needle biopsy (CNB) which can upgrade to malignancy at excision. There is limited data on RS detection and upgrade rates with more sensitive imaging such as magnetic resonance imaging (MRI) and none during their detection for breast cancer workup and its implication on patient treatment decisions. MethodsA retrospective institutional study of RS diagnosed on CNB between January 2008 and December 2017 was conducted. Clinicopathologic and radiologic features of RS, patient treatment decisions, upgrade rates and long-term follow-up were examined. ResultsWe identified 133 patients with RS on CNB, of whom 106 opted for surgery for an upgrade rate to malignancy of 1.9%, 2 patients. Radial scar was diagnosed on mammogram in 60%, MRI in 25% and ultrasound in 15% of patients. In this cohort, 32 patients had their RS detected during breast cancer workup (coexistent group) and they were more likely to have their radial scar detected by MRI (60% vs. 14%, P < .001) and undergo more extensive surgery (94% vs. 75%, P = .02). Among the 27 patients electing observation of their RS, only one (3.7%) developed breast cancer. ConclusionsOur results show an extremely low upgrade rate to malignancy of RS, regardless if there is coexisting breast cancer elsewhere. Despite this, RS still prompted more extensive surgical excisions. The findings do not support excision of RS even among breast cancer patients when identified at a separate site from their cancer.

A Comparison of the Prognostic Effects of Fine Needle Aspiration and Core Needle Biopsy in Patients with Breast Cancer: A Nationwide Multicenter Prospective Registry.

(1) Background: Breast core needle biopsy (CNB) is preferred over fine needle aspiration (FNA) as it has higher sensitivity and specificity and enables immunohistochemical evaluation. However, breast FNA remains widely used because of its low cost, minimally invasive nature, and quick results. Studies analyzing the effects of each test on the prognoses of patients with breast cancer are scarce and controversial, and the criteria for test selection remain unknown. (2) Methods: This study included adult female patients who underwent breast cancer surgery at 102 general hospitals. The trend of breast biopsies over time was analyzed, and the prognoses of patients with breast cancer who underwent CNB and FNA were compared. (3) Results: This study included 73,644 patients who underwent FNA (n = 8027) and CNB (n = 65,617). A multivariate Cox regression analysis showed that patients diagnosed using FNA had significantly worse overall survival (OS) and breast-cancer-specific survival (BCSS) than those diagnosed using CNB. In the subgroup analysis, patients with breast imaging reporting and data system (BI-RADS) 5 lesions, palpable tumors, or centrally located tumors had significantly worse OS and BCSS with FNA than with CNB. (4) Conclusions: CNB should be performed preferentially instead of FNA in patients with BI-RADS 5 lesions and nonpalpable or centrally located tumors.

Application of endoscopic ultrasound guided needle biopsy in patients with pancreatic tumor

Background: Pancreatic cancer is a rapidly progressive disease, low 5-year survival rate (less than 11%). However, if pancreatic tumors detected and treated early, the 5-year survival rate improves significantly. The diagnosis of pancreatic cancer, besides conventional imaging measures. It has been a challenge to obtain a histopathological gold standard for the diagnosis of pancreatic cancer. The advent of endoscopic ultrasound and endoscopic ultrasound guide fine-needle biopsy (EUS-FNB) has created a major turning point in the histopathological diagnosis of pancreatic tumors. In Vietnam, there have not been many announcements about the effectiveness and safety of this technique. Objectives: 1. To evaluate the effectiveness and safety of EUS-FNB procedure in patients with pancreatic tumor; 2. To investigate some related factors between EUS-FNB procedure and histopathological results. Subjects and methods: Descriptive cross-sectional study on patients who had a pancreatic tumor or suspected pancreatic tumor and underwent EUS-FNB at the endoscopy department of Cho Ray Hospital from January 1th, 2021 to October 15th 2021. Results: There were 97 pancreatic tumor patients who underwent EUS-FNB, without significant complications. 80.4% of patients had histopathological result to diagnose the tumor nature, 19.6% patients had no tumor cells in the specimen. FNB with 19G needle gave higher histopathological results than 22G needle (p &lt; 0.01). There was a significant difference in histopathological results between the tissue sample length segments obtained &lt; 4 mm, 4 - 7 mm and ≥ 8 mm. Conclusion: EUS-FNB is effective and ralatively safe procedure in patients with pancreatic tumor. There was a significant relationship between the needle size for FNB, the length of the tissue obtained with the histopathological results. Key words: Endoscopic Ultrasound, Pancreatic tumor, EUS-FNB

Clinical significance of tumor cell seeding associated with needle biopsy in patients with breast cancer

Background/ObjectiveThe occurrence of iatrogenic tumor cell seeding (seeding) in needle tract scars formed by core needle biopsy (CNB) or vacuum-assisted biopsy (VAB) is well known. Some risk factors for seeding have been reported, but the clinicopathological risk factors and its prognosis have not been fully investigated. We evaluated the clinical features and prognosis of seeding. MethodsWe included 4405 patients who had undergone surgery (lumpectomy or mastectomy) with a diagnosis of breast cancer by preoperative CNB or VAB at our hospital between January 2012 and February 2021. Data of patients with confirmed presence of seeding in resected specimens were collected from pathological records. We analyzed the risk factors of seeding using logistic regression analysis and compared the ipsilateral breast tumor recurrence (IBTR) rate between cases based on the presence or absence of seeding in the lumpectomy group. ResultsOf the 4405 patients, 133 (3.0%) had confirmed seeding. Univariate analysis revealed the association of clinicopathological features of seeding with lower nuclear grade (NG1 vs NG2-3; p = 0.043), lower Ki-67 (<30 vs. ≥30; p = 0.049), estrogen receptor (ER) positivity (positive vs negative; p<0.01), and human epidermal growth factor receptor 2 (HER2) negativity (negative vs positive; p = 0.016). Multivariate analysis showed ER positivity (odds ratio, 5.23; p<0.05) as an independent risk factor of seeding. The IBTR rate was not significantly different between the seeding and non-seeding groups. ConclusionsSeeding was more likely to occur in ER positive, HER2 negative carcinomas with less aggressive features, and may remain subclinical if adequate adjuvant treatments are administered.

Comparative study on efficacy and safety of ultrasound guided transoral and transcutaneous core needle biopsy in patients with oral masses

BackgroundUltrasound (US) guided transoral biopsy is a novel and safe procedure for obtaining tissue in patients with oral masses. However, this procedure is less commonly used in comparison to US guided transcutaneous biopsy. The aim of this study is to compare the efficacy and safety of US-guided transoral and transcutaneous core needle biopsy (CNB) in patients with oral masses.MethodsFrom November 2019 to March 2021, consecutive patients with oral masses were randomly assigned to undergo US-guided transoral CNB (transoral group) and US-guided transcutaneous CNB from a submental approach (transcutaneous group). During the operation, procedure time, intra‑operative blood loss volume, diagnostic performance, rate of complications and pain level were recorded and compared.ResultsThere were 112 patients (62 in the transoral group and 50 in the transcutaneous group) evaluated in this study. The postprocedural complication rate of the transcutaneous group was significantly higher than the transoral group (24% vs. 0%, P = 0.000). There was no significant difference in accuracy (95.2% vs. 88%, P = 0.30), biopsy time (76 ± 12 s vs. 80 ± 13 s, p = 0.09), blood losses (2.6 ± 0.5 mL vs. 2.7 ± 0.4 mL, p = 0.17) and visual analogue score (p = 0.327 and p = 0.444 before and after the sampling procedure) between the two groups.ConclusionUS-guided transoral CNB results in high rates of technical success and lower rates of postprocedural complications.

Endoscopic ultrasound guided fine needle biopsy in patients with suspected gastric linitis plastica

BackgroundGastric linitis plastica (GLP) is a diffuse infiltrating type of gastric adenocarcinoma. It is associated with a poor prognosis and a five-year survival of 3–10%. The infiltrating profile of this tumor explains the low yield of the superficial mucosal biospies. The objective of this study was to investigate the role of endoscopic ultrasound-fine needle biopsy (EUS-FNB) in the diagnosis of GLP. MethodsWe performed a retrospective analysis including all patients who had an EUS-FNB, at a tertiary referral center, over the last 3 years. The primary outcome was the sensitivity of EUS-FNB in patients with suspected GLP. ResultsBetween January 2017 and December 2020, 34 patients had an EUS-FNB for suspected GLP. Ten patients had a diagnostic of GLP. This diagnosis was obtained by EUS-FNB in 90% (9/10) of the cases. Eight patients had at least one previous esophagogastroduodenoscopy (EGD) with negative mucosal biopsies. Gastric EUS-FNB helped diagnose other serious conditions in 47% (16/34) of cases with inconclusive mucosal biopsies. ConclusionGastric EUS-FNB in patients with suspected GLP and normal endoscopic mucosal biopsies may lead to a positive diagnosis of GLP in 90% of cases without notable adverse events. This technique should be considered as a second step in the setting of suspicion of GLP after inconclusive mucosal biopsies.

Image-guided percutaneous needle biopsy for the diagnosis of cancer of unknown primary.

This study aimed to assess the efficacy of image-guided percutaneous needle biopsy in patients with suspected cancer of unknown primary. We conducted a retrospective observational study. Among 291 patients with suspected cancer of unknown primary who were referred to our institution between April 2011 and March 2014, 89 who underwent image-guided percutaneous needle biopsy and 27 who underwent surgical biopsy were defined as the image-guided percutaneous needle biopsy group and the surgical group, respectively. Patient backgrounds, diagnostic yields, promptness of biopsy, general anesthesia rates, and severe complication rates were compared between the two groups. There was no significant difference in the patient backgrounds of the two groups. The diagnostic yields were 98.9% (95% confidence interval, 93.9%-99.8%) in the image-guided percutaneous needle biopsy group and 100% (95% confidence interval, 87.5%-100%) in the surgical biopsy group (no significant difference; p=1.0). The mean time to biopsy was significantly shorter (6.5 days vs. 21.3 days; p<.0001) and general anesthesia was used in significantly fewer patients (0%vs. 40.7%; p<.0001) in the image-guided percutaneous needle biopsy group. There was no significant difference in the rate of serious complications between the two groups (p=1.0). As a biopsy procedure for patients with suspected cancer of unknown primary, image-guided percutaneous needle biopsy is equally diagnostic and safe for surgical biopsy and might be preferable to surgical biopsy in terms of promptness and not requiring general anesthesia.

Diagnostic Value of Ultrasound-Guided Pleural Biopsy in Patients with Recurrent Pleural Effusion

Background: Establishing a definite diagnosis in cases of pleural effusion is sometimes challenging. Adding ultrasound-guided tru-cut biopsy at the time of obtaining pleural fluid for analysis may increase the diagnostic yield in such cases. Objective: The aim of the current work was to assess the diagnostic yield and the safety of percutaneous ultrasound guided tru-cut needle biopsy in patients with recurrent undiagnosed pleural effusion. Patients and Methods: A retrospective observational study including 45 patients with recurrent undiagnosed pleural effusion who underwent ultrasound-guided tru-cut needle biopsy in the period between January 2019 and October 2020. Results: By using ultrasound-guided needle biopsy, we were able to reach a final histopathological diagnosis in 40 patients with a diagnostic yield of 88.8%. Only 5 cases remained undiagnosed (11.1%). Mesothelioma was found in 13 cases (28.9%) and bronchogenic carcinoma in 7 cases (15.5%). Post-procedural complications included 1 case of pneumothorax (2.2%) and 1 case of hemothorax (2.2%) all resolving with the small caliber chest drain that was inserted at the conclusion of the procedure. Conclusion: It could be concluded that ultrasound-guided needle biopsy is a safe procedure that can be useful in establishing a diagnosis in patients with recurrent pleural effusion. Its high diagnostic yield, while being simpler and cheaper than CT guided biopsy or thoracoscopy, makes it a suitable option in our clinical settings. More studies are needed to validate our findings.

Analysis of Risk Factors of Bleeding Complications in Percutaneous Needle Biopsy of Liver Occupying Lesions.

PurposeTo search for risk factors for bleeding complications after percutaneous biopsy of primary or secondary space-occupying lesions of liver guided by imaging.MethodsConsecutive 555 patients with liver space-occupying lesions who underwent ultrasound or CT-guided percutaneous biopsy in our hospital from January 2015 to January 2021 were retrospectively analyzed. Those who cannot cooperate with breath-holding and cannot successfully complete the operation, cytology, and incomplete clinical data. After screening, a total of 502 patients were enrolled, including 313 males and 189 females. Abdominal cavity or liver subcapsular hemorrhage after procedure was used as the dependent variable, and patient’s gender, age, pathological results, tumor size, preoperative platelets and international normalized ratio (INR) and hemoglobin as independent variables. All independent variables were analyzed by a single factor logistic regression analysis. The independent variables with P<0.05 were included in the regression model and analyzed by multivariate logistic regression analysis to search for the risk factors for bleeding complications of liver space-occupying lesions.ResultsA total of 502 patients with liver space-occupying lesions undergoing percutaneous liver biopsy guided by imaging equipment were included. Twenty-six of 502 (5.2%) patients occurred abdominal cavity or liver sub-capsule bleeding after procedure. Univariate logistic regression analysis observed that liver cirrhosis, the number of punctured tissues and the depth of puncture were related to bleeding complications after puncturing. Multivariate logistic regression analysis showed that liver cirrhosis and puncture depth were risk factors for bleeding complications (P<0.05). The ROC curve for predicting bleeding complications after needle biopsy in patients with liver cirrhosis has a sensitivity of 94.3% and a specificity of 46.2%.ConclusionLiver cirrhosis and puncture depth are risk factors for bleeding complications during percutaneous biopsy of liver occupying lesions.

Development and Validation of a Simple-to-Use Nomogram for Predicting the Upgrade of Atypical Ductal Hyperplasia on Core Needle Biopsy in Ultrasound-Detected Breast Lesions.

BackgroundThe rate of carcinoma upgrade for atypical ductal hyperplasia (ADH) diagnosed on core needle biopsy (CNB) is variable on open excision. The purpose of the present study was to develop and validate a simple-to-use nomogram for predicting the upgrade of ADH diagnosed with ultrasound (US)-guided core needle biopsy in patients with US-detected breast lesions.MethodsTwo retrospective sets, the training set (n = 401) and the validation set (n = 186), from Fudan University Shanghai Cancer Center between January 2014 and December 2019 were retrospectively analyzed. Clinicopathological and US features were selected using univariate and multivariable logistic regression, and the significant features were incorporated to build a nomogram model. Model discrimination and calibration were assessed in the training set and validation set.ResultsOf the 587 ADH biopsies, 67.7% (training set: 267/401, 66.6%; validation set: 128/186, 68.8%) were upgraded to cancers. In the multivariable analysis, the risk factors were age [odds ratio (OR) 2.739, 95% confidence interval (CI): 1.525–5.672], mass palpation (OR 3.008, 95% CI: 1.624–5.672), calcifications on US (OR 4.752, 95% CI: 2.569–9.276), ADH extent (OR 3.150, 95% CI: 1.951–5.155), and suspected malignancy (OR 4.162, CI: 2.289–7.980). The model showed good discrimination, with an area under curve (AUC) of 0.783 (95% CI: 0.736–0.831), and good calibration (p = 0.543). The application of the nomogram in the validation set still had good discrimination (AUC = 0.753, 95% CI: 0.666–0.841) and calibration (p = 0.565). Instead of surgical excision of all ADHs, if those categorized with the model to be at low risk for upgrade were surveillanced and the remainder were excised, then 63.7% (37/58) of surgeries of benign lesions could have been avoided and 78.1% (100/128) malignant lesions could be treated in time.ConclusionsThis study developed a simple-to-use nomogram by incorporating clinicopathological and US features with the overarching goal of predicting the probability of upgrade in women with ADH. The nomogram could be expected to decrease unnecessary surgery by nearly two-third and to identify most of the malignant lesions, helping guide clinical decision making with regard to surveillance versus surgical excision of ADH lesions.

Diagnostic accuracy of positron emission tomography/computed tomography-driven biopsy for the diagnosis of lymphoma

IntroductionBiopsy of affected tissue is required for lymphoma diagnosis and to plan treatment. Open incisional biopsy is traditionally the method of choice. Nevertheless, it requires hospitalization, availability of an operating room, and sometimes general anesthesia, and it is associated with several drawbacks. Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) can be potentially used to drive biopsy to the most metabolically active area within a lymph node or extranodal masses.MethodsA study of diagnostic accuracy was conducted to assess the performance of a PET-driven needle biopsy in patients with suspect active lymphoma.ResultsOverall, 99 procedures have been performed: three (3.0%) were interrupted because of pain but were successfully repeated in two cases. Median SUVmax of target lesions was 10.7. In 84/96 cases, the tissue was considered adequate to formulate a diagnosis (diagnostic yield of 87.5%) and to guide the following clinical decision. The target specimen was a lymph node in 60 cases and an extranodal site in 36. No serious adverse events occurred. The sensitivity of this procedure was 96%, with a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 75%.ConclusionPatients can benefit from a minimally invasive procedure which allows a timely and accurate diagnosis of lymphoma at onset or relapse.

Identification of circulating tumor cells using 4-color fluorescence in situ hybridization: Validation of a noninvasive aid for ruling out lung cancer in patients with low-dose computed tomography-detected lung nodules.

Approximately one third of needle biopsies that are performed to rule out malignancy of indeterminate pulmonary nodules detected radiologically during lung cancer screening are negative, thus exposing cancer-free patients to risks of pneumothorax, bleeding, and infection. A noninvasive confirmatory tool (eg, liquid biopsy) is urgently needed in the lung cancer diagnosis setting to stratify patients who should receive biopsy versus those who should be monitored. A novel antigen-independent, 4-color fluorescence in situ hybridization (FISH)-based method was developed to detect circulating tumor cells (CTCs) with abnormalities in gene copy numbers in mononuclear cell-enriched peripheral blood samples from patients with (n=107) and without (n=100) lung cancer. Identification of CTCs using FISH probes at 10q22.3/CEP10 and 3p22.1/3q29 detected lung cancer cases with 94.2% accuracy, 89% sensitivity, and 100% specificity compared with biopsy. The high accuracy of this liquid biopsy method suggests that it may be used as a noninvasive decision tool to reduce the frequency of unnecessary needle biopsy in patients with benign pulmonary lesions.

Localized Lymphomas Presenting in the Chest Wall: A Rare Case Report

A 35-year-old male presented with a history of chest wall pain and swelling. It was decided to perform a CT-scan of the thorax that revealed of a rib involvement in the right hemithorax (Fig 1). We evaluated the yield of core needle biopsy in patients that the was diagnosed lymphoproliferative disorder. Investigation abdominal and pelvic CT scan and blood tests were found no other lesions. The patient underwent resection with reconstruction mesh and cement and muscle flap (Fig 2). Final Pathologic Diagnoses for Patients was reported with Lymphoma.

Diagnostic efficacy and molecular testing by combined fine-needle aspiration and core needle biopsy in patients with a lung nodule.

Combined image-guided fine-needle aspiration biopsy (FNA) and core needle biopsy (CNB) has become the standard of care for diagnosis and/or molecular testing for patients with a solitary lung nodule at our institution. Our purpose was to evaluate the efficacy of this practice. We identified patients who underwent combined lung FNA/CNB during 2012 at our institution. A total of 667 patients who underwent 682 combined lung FNA/CNB procedures were included in the study, including 355 men and 312 women. Combined lung FNA/CNB procedures were performed by a radiologist. The adequacy of FNA specimens was assessed immediately by a cytopathologist. The FNA and CNB specimens were interpreted separately by a cytopathologist and a surgical pathologist, respectively. The diagnostic accuracy of the combined technique was determined. The rate of diagnostic consistency between FNA and CNB was 83.4%, and the rate of diagnostic accuracy for malignancy was 98.5% for combined FNA/CNB. Combined FNA/CNB showed a high diagnostic efficacy for malignancy (sensitivity, 97.6%; specificity, 100%). Combined FNA/CNB had a lower false-negative rate for malignancy (2.2%) than either FNA (7.2%) or CNB (6.2%) alone. FNA contributed to 10.3% of molecular analyses as a complementary tissue source. Combined lung FNA/CNB has high diagnostic efficacy for malignancy and a lower false-negative rate than either procedure alone. FNA was a valuable complement to CNB for molecular testing, potentially reducing patient inconvenience and morbidity associated with repeated lung needle biopsy.

Complications and Accuracy of Computed Tomography-Guided Transthoracic Needle Biopsy in Patients Over 80 Years of Age: Erratum.

Complications and Accuracy of Computed Tomography-Guided Transthoracic Needle Biopsy in Patients Over 80 Years of Age: Erratum.

CT-Guided Percutaneous Needle Biopsy in Patients with Suspected Retroperitoneal Fibrosis: A Retrospective Cohort Study.

The outcome of CT-guided biopsy in patients with suspected retroperitoneal fibrosis (RF), regarded as technically challenging, remains unclear. This study aimed to evaluate the results of CT-guided biopsy in patients with lesions considered in the differential diagnosis of RF and compare them with results from patients with other retroperitoneal lesions. Patients who underwent CT-guided biopsy of retroperitoneal lesions between January 2010 and September 2018 were retrospectively reviewed. The study cohort with retroperitoneal lesions surrounding the infra-abdominal aorta, iliac vessels, and/or ureters was divided into two groups: Group F included patients with lesions for which RF was considered in the differential diagnosis, and Group C comprised patients with a retroperitoneal mass or lymphadenopathy. Lesion size and depth, and biopsy details including technical success, position, procedure time, diagnostic yield, and complications between the two groups were compared. Group F included 27 patients (mean age 68.5years ± 11.6, 17 male) and Group C 30 patients (mean age 65.0years ± 11.8, 16 male). The short axis was significantly smaller in Group F than in Group C (19mm vs 26mm, P = 0.041), and procedure time was significantly longer in Group F than in Group C (31.5min ± 13.2 vs 20.3min ± 8.4, P = 0.001). Technical success rate (93% vs 100%), accuracy (93% vs 93%), and complications (3.7% vs 10%) between Groups F and C were not significantly different. CT-guided biopsy of patients with suspected RF is considered safe and effective.

Sa1399 – Pancreatic Functional and Structural Evaluation with Fecal Elastase 1, Endoscopic Ultrasound with Fine Needle Biopsy in Patients with Pancreatic Steatosis

Sa1399 – Pancreatic Functional and Structural Evaluation with Fecal Elastase 1, Endoscopic Ultrasound with Fine Needle Biopsy in Patients with Pancreatic Steatosis

Complications and Accuracy of Computed Tomography-guided Transthoracic Needle Biopsy in Patients Over 80 Years of Age.

The purpose of this study was to evaluate the complications and diagnostic accuracy of computed tomography-guided percutaneous transthoracic needle biopsy (PTNB) in patients aged 80 years and older. Consecutive PTNB procedures performed in an academic institution between July 2009 and June 2013 were reviewed. Procedures were performed according to a standard protocol using conscious sedation and rapid on-site pathology evaluation. Patient demographics, lesion characteristics, complications, and final tissue diagnosis were reviewed. Patients below 80 years of age and over 80 years were compared using binary logistic regression. Of 894 biopsies, 141 (16%) were performed on patients over 80 years of age. Comparison of patients over and below 80 years of age did not differ significantly with regard to lesion size and morphology (P=0.663 and 0.453, respectively), and diagnostic accuracy (P=0.268). Pneumothorax rates were 23% versus 24% (P=0.682), and chest tube insertion was required in 2% of both groups (P=0.924). Hemoptysis rates were 3% versus 2% (P=0.376). PTNB is a safe and accurate procedure in patients aged 80 years and older. Complications and diagnostic accuracy are similar to those observed in younger patients.

The role of percutaneous ultrasound-guided true-cut needle biopsy in patients with sheet-like pleural thickening

Background Pleural biopsy for histological confirmation is the standard diagnostic procedure for pleural diseases. Aim To identify the role of percutaneous ultrasound (US)-guided true-cut needle biopsy in patients with sheet-like pleural thickening. Patients and methods A prospective interventional simple controlled trial was conducted on 60 patients with computed tomographic evidence of pleural thickening. Percutaneous US-guided pleural biopsies using a true-cut needle were performed for pathological tissue characterization; complications were recorded. Results All patients were diagnosed, with only five (8%) patients found to have self-limiting pneumothorax, with no need for a chest tube. Fifty-three percent of patients had a histopathological diagnosis of mesothelioma, 14% had a histopathological result of adenocarcinoma, whereas 33% had chronic fibrosing pleuritis. Conclusion The US-guided procedure has a major advantage as it is being real time, rapid, available bedside, and well tolerated, and no serious complications were observed in good case selection and procedure.