Percutaneous Pulmonary Biopsy Research Articles

Washing solution of tissue biopsy compared with paraffin-embedded tissue for NSCLC gene test.

e21104 Background: Non-small cell lung cancer (NSCLC) is the leading cause of cancer related death, whose targeted therapy is precisely based on gene type. Gene diagnosis is as important as pathological diagnosis and driver gene mutations should be detected as soon as possible. There are generally a few sources to obtain patients’ deoxyribonucleic acid (DNA), such as paraffin tissue of tumor, cytological specimens from bronchoalveolar fluid or pleural effusion, free DNA from blood, hydrothorax, ascite, or cerebrospinal fluid. Our research aims to find out whether washing solution of lung mass biopsy in double distilled water is feasible for detecting gene mutation, and whether its gene type is consistent with that from Next Generation Sequencing (NGS) of paraffin tissue. Methods: 25 clinically diagnosed NSCLC patients from Department of Oncology, Second Xiangya Hospital, Central South University were collected. We used double distilled water to wash the CT-guided percutaneous pulmonary mass biopsy, which was processed to extract DNA. DNA samples were tested for epidermal growth factor receptor (EGFR) gene mutation by amplification refractory mutation system (ARMS)-PCR. 6 of them as well as all 25 paraffin tissue samples were tested for large panel gene mutations by NGS. The gene type consistency between washing solution and paraffin tissue was analyzed by GraphPad Prism V9.4.1. Results: 16 of 25 washing solution DNA samples tested by ARMS-PCR were EGFR mutation positive, including 9 cases of EGFR exon19 deletion, 5 cases of EGFR exon21 L858R, and 2 cases of EGFR exon21 L858R and T790M. Other 9 of 25 samples were EGFR mutation negative. 17 of 25 paraffin tissue samples tested by NGS were EGFR mutation positive, including 9 cases of EGFR exon19 deletion, 7 cases of EGFR exon21 L858R, and 1 case of EGFR exon21 L858R with T790M. There was one washing solution sample showed no EGFR mutation while its tissue sample showed EGFR exon21 L858R. Compared to NGS on paraffin tissue, the sensibility of ARMS-PCR on washing solution was 94.1%. The specificity was 100%, positive predictive value was 100%, negative predictive value was 88.9%, accuracy rate was 96.0%, misdiagnosis rate was 0, and omission diagnostic rate was 5.9%. EGFR types of 6 washing solution samples tested by NGS were exactly the same as that by ARMS-PCR and that of paraffin tissue samples by NGS. The time to obtain gene result was significantly different. ARMS-PCR of washing solution took 1 day, NGS of washing solution took around 7 days, while pathological examination and NGS of paraffin-embedded tissue took around 14 days. Conclusions: The washing solution of CT-guided percutaneous lung mass biopsy in double distilled water is feasible to obtain EGFR type rapidly and efficiently for NSCLC. It is the fastest method to get patients’ gene type at present. Thus, the washing solution of biopsy could be a new DNA source for NSCLC gene test and making decision on targeted therapy ahead of time.

Cryptococcal antigen testing of lung tissue homogenate improves pulmonary cryptococcosis diagnosis: Two case reports

BACKGROUNDPulmonary cryptococcosis (PC) is an opportunistic infectious disease of the respiratory system. Lung tissue biopsies, culture of respiratory samples (e.g., sputum, lung tissue, pleural fluid, and bronchoalveolar lavage fluid), and cryptococcal antigen (CrAg) testing are helpful for a definitive diagnosis. However, these tests are sometimes falsely negative. PC is often misdiagnosed or underdiagnosed owing to the absence of obvert symptoms, poor imaging specificity, and false-negative laboratory tests.CASE SUMMARYWe report two female patients who underwent computed tomography-guided percutaneous needle pulmonary biopsy of a lung nodule for a confirmed diagnosis. In both patients, the CrAg test on the lung biopsy tissue homogenate was positive, while the serum CrAg test was negative. Combined with the lung tissue pathology, we made the diagnosis of PC. Antifungal therapy was effective in both patients.CONCLUSIONGiven the findings of our cases and the literature review, lung tissue homogenate CrAg testing can be helpful in improving the diagnosis of PC.

Multimodal echocardiography in the diagnosis of masses localized to the proximal portions of pulmonary arteries.

Proximal pulmonary artery masses are exceedingly rare, and their diagnosis and therapy are important and challenging for clinicians. This study reviews our experience exploring the value of a combination of transthoracic echocardiography and contrast echocardiography for the differential diagnosis of proximal pulmonary artery masses. Between January 2018 and June 2021, 44 patients diagnosed with a mass attached to the major pulmonary artery and straddling the bilateral pulmonary arteries or pulmonary valve on transthoracic echocardiography were referred to this study. Contrast echocardiography was performed in 17 patients. Masses were diagnosed based on their site of attachment, shape, size, mobility, hemodynamic consequences on transthoracic echocardiography, and tissue perfusion on contrast echocardiographic perfusion imaging. Pathological data were collected from medical records and analyzed. The most frequent location of proximal pulmonary artery masses was the major pulmonary artery trunk. Twelve patients underwent complete mass resection, whereas nine patients underwent percutaneous pulmonary artery biopsy puncture and had a pathological diagnosis. Another 24 patients were confirmed with the validation methods. Contrast echocardiography has good sensitivity and specificity for differentiating thrombi from pulmonary artery sarcomas (PAS). The mass types were distributed as follows: thrombi (19, 43%), PAS (15, 34%), metastatic tumors (6, 14%), vegetations (3, 7%), and primary benign lesions (1, 2%). The majority of proximal pulmonary artery masses were thrombi or PAS. A combination of transthoracic echocardiography and contrast echocardiography offers advantages in the early identification of proximal pulmonary masses and provides clinically important information about the characteristics of masses, especially for differentiating thrombi from PAS.

Preliminary recommendations for lung surgery during COVID-19 epidemic period.

Preliminary recommendations for lung surgery during COVID-19 epidemic period.

Complications and influencing factors of pneumoconiosis patients undergoing CT guided percutaneous lung biopsy

Objective: To investigate the safety and influencing factors of ct-guided percutaneous lung biopsy in pneumoconiosis patients. Methods: The data of 63 patients with pneumoconiosis who underwent ct-guided percutaneous lung biopsy in our hospital were studied to analyze the incidence of complications and influencing factors of percutaneous lung biopsy. Results: 63 cases of pneumoconiosis patients received CT guided percutaneous lung biopsy. There were 29 cases of complications (46.03%) , including 20 pneumothorax (37.75%) , 12 bleeding (19.05%) , and 3 cases of liquid pneumothorax (4.76%) . The single factor chi square analysis showed that there were significant differences in age, depth of focus, puncture position and puncture times (P<0.05) , and there was significant difference between the occurrence of hemorrhage and age, type of focus, size of focus, and the location of puncture site (P<0.05) . The unconditional LogisticL multiple factor regression analysis showed that the depth of the lesion was an independent risk factor for concurrency pneumothorax, and the size of the lesion was an independent risk factor for bleeding. Conclusion: Complications of CT-guided percutaneous pulmonary biopsy are mainly pneumothorax and hemorrhage. Age, focus type, focus size, focus depth, puncture site, and puncture times are all the factors of complications.

Salmeterol undergoes enantioselective bronchopulmonary distribution with receptor localisation a likely determinant of duration of action

BackgroundSalmeterol (a long acting beta2-agonist) is a chiral molecule. (RR)-salmeterol is responsible for pharmacological effect, but basic knowledge of enantioselective pulmonary pharmacodynamics and pharmacokinetics of salmeterol remains unknown. There are safety concerns with (S)-enantiomers of beta2-agonists, with suggestions that these enantiomers may increase bronchial hyperresponsivneness in asthma patients. MethodologyHorses (n = 12) received racemic (rac-) salmeterol 250 μg via inhalation. Enantioselective UPLC–MS/MS was used to determine (R)- and (S)-salmeterol concentrations in pulmonary epithelial lining fluid (PELF) sampled 2, 5, 10 and 15 min after administration, in central lung (endoscopic bronchial biopsy) and peripheral lung (percutaneous pulmonary biopsy) tissues (at 20 and 25 min respectively), and in plasma samples. ResultsPhysiologically relevant tissue concentrations were found for both enantiomers, with median levels greater in central than peripheral lung (equivalent to 32 and 5 mM (R)-salmeterol for central and peripheral lung respectively). Levels in PELF decreased around 50% over 15 min and enantioselective distribution was observed in the central lung with levels of (R)-salmeterol around 30% higher than (S)-salmeterol. ConclusionSalmeterol distribution is enantioselective in the central lung. This suggests duration of action is more likely associated with specific B2ADR localisation effects rather than non-specific physiochemical factors which would not be enantioselective.

Analysis of the clinical features of invasive bronchopulmonary aspergillosis.

Early diagnosis of invasive bronchopulmonary aspergillosis (IBPA) is difficult, so the mortality rate is high. To discuss the clinical features of IBPA. We retrospectively analyzed the clinical features, imaging findings, laboratory test, diagnosis and treatment of 115 patients with IBPA diagnosed from October 2004 to June 2013 in Zhongshan Hospital, Fudan University. The main clinical manifestations were cough in 58 patients (50.4%), expectoration in 37 patients (32.2%), fever in 18 patients (15.7%), shortness of breath in 26 patients (22.6%), hemoptysis in 26 patients (22.6%) and chest pain in 7 patients (6.0%). The main CT findings were nodules in 35 patients (30.4%), consolidation shadows or patchy shadows in 62 patients (53.9%) and cavity in 14 patients (12.2%). Percutaneous pulmonary biopsy was conducted in 25 patients (21.7%), TBLB in 58 patients (50.4%) and thoracoscopic surgery in 32 patients (27.8%). The positive rate of GM test was 73.5% (72/98). Thirty patients who received lobectomy were followed up for 1-3years. Fifty-five patients who received monotherapy with antifungal agents were followed up for 1-3years, and 12 patients were healed. The lesions for 23 patients were obviously absorbed, 10 patients had aggravation and two patients died. The clinical manifestations of IBPA were unspecific. The main symptoms were cough and expectorate. Patients with different immunologic function had different imaging findings. The halo sign and new moon sign for diagnosis was not as common as reported. Interventional therapy under bronchoscope is very important for patients with ATB.

Bronchopulmonary pharmacokinetics of (R)-salbutamol and (S)-salbutamol enantiomers in pulmonary epithelial lining fluid and lung tissue of horses.

Salbutamol is usually administered as a racemic mixture but little is known about the enantioselectivity of salbutamol pharmacokinetics in the lung. This study was designed to investigate enantiomer concentrations in lung tissue after inhaled dosing. Horses (n=12) received racemic salbutamol 1000 μg via inhalation. Enantioselective ultra performance liquid chromatography-tandem mass spectrometry was used to determine salbutamol concentrations in pulmonary epithelial lining fluid (PELF) sampled 2, 5, 10 and 15min after administration, in central lung (endoscopic bronchial biopsy) and peripheral lung (percutaneous pulmonary biopsy) tissues (at 20 and 25min respectively), and in plasma samples. Mean±95% confidence interval (CI) yield of PELF was 57±10mg. Initial mean±95%CI (R)- and (S)-salbutamol PELF concentrations were 389±189ngg-1 and 378±177ngg-1 respectively, and both reduced approximately 50% by 15min. Mean±95%CI central lung levels of drug were higher than peripheral lung tissue for both (R)-salbutamol (875±945 vs. 49.5±12ngg-1 ) and (S)-salbutamol (877±955 vs. 50.9±12ngg-1 ) respectively. There was no evidence of enantioselectivity in PELF or central lung but minor (~2%) enantioselectivity was observed in the peripheral lung. Enantioselectivity was clearly evident in plasma with (S):(R) ratio of 1.25 and 1.14 for both area under the concentration-time curve (0-25min) and Cmax respectively. PELF sampling in horses offers sufficient yield allowing direct detection of drug and, combined with tissue sampling, is a valuable model to investigate bronchopulmonary pharmacokinetics. Salbutamol did not demonstrate enantioselectivity in PELF or central lung tissue uptake following acute dosing, however, enantioselective plasma concentrations were demonstrated, with minor enantioselectivity in the peripheral lung.

MR-guided percutaneous biopsy of solitary pulmonary lesions using a 1.0-T open high-field MRI scanner with respiratory gating.

To prospectively evaluate the feasibility, safety and accuracy of MR-guided percutaneous biopsy of solitary pulmonary lesions using a 1.0-T open MR scanner with respiratory gating. Sixty-five patients with 65 solitary pulmonary lesions underwent MR-guided percutaneous coaxial cutting needle biopsy using a 1.0-T open MR scanner with respiratory gating. Lesions were divided into two groups according to maximum lesion diameters: ≤2.0cm (n = 31) and >2.0cm (n = 34). The final diagnosis was established in surgery and subsequent histology. Diagnostic accuracy, sensitivity and specificity were compared between the groups using Fisher's exact test. Accuracy, sensitivity and specificity of MRI-guided percutaneous pulmonary biopsy in diagnosing malignancy were 96.9%, 96.4% and 100%, respectively. Accuracy, sensitivity and specificity were 96.8%, 96.3% and 100% for lesions 2.0cm or smaller and 97.1%, 96.4% and 100%, respectively, for lesions larger than 2.0cm. There was no significant difference between the two groups (P > 0.05). Biopsy-induced complications encountered were pneumothorax in 12.3% (8/65) and haemoptysis in 4.6% (3/65). There were no serious complications. MRI-guided percutaneous biopsy using a 1.0-T open MR scanner with respiratory gating is an accurate and safe diagnostic technique in evaluation of pulmonary lesions. • MRI-guided percutaneous lung biopsy using a 1.0-T open MR scanner is feasibility. • 96.9% differentiation accuracy of malignant and benign lung lesions is possible. • No serious complications occurred in MRI-guided lung biopsy.

Educational Exhibit Abstract No. 469 - CT fluoroscopy guidance versus conventional CT guidance for percutaneous pulmonary nodule biopsy- a comparison of patient radiation exposure, procedural time, and complication rates

Educational Exhibit Abstract No. 469 - CT fluoroscopy guidance versus conventional CT guidance for percutaneous pulmonary nodule biopsy- a comparison of patient radiation exposure, procedural time, and complication rates

CT-guided core biopsy and percutaneous fiducial seed placement in the lung: Can these procedures be combined without an increase in complication rate or decrease in technical success?

ObjectiveTo determine if concomitant CT-guided biopsy and percutaneous fiducial seed placement in the lung can be performed in a selective patient population without increased complication or decreased success rates compared to either procedure alone. Materials and methodsAn IRB approved retrospective analysis of 285 consecutive patients that underwent CT-guided placement of fiducial seeds in the lung alone (N=63), with concomitant core biopsy (N=53) or only core biopsy (N=169) was performed. Variables compared included: patient demographics, lesion size, depth from pleura, needle size, number of passes through pleura, number and size of core biopsies, number of seeds placed and technical success rates. Statistical analysis was performed using univariate and multivariate pair-wise comparisons. ResultsA pathologic diagnosis of malignancy was confirmed in all cases undergoing seed placement alone and seed placement with concurrent biopsy, and in 144 of the biopsy alone lesions. On univariate analysis, major complication rates were similar for all three groups as were lesion size, depth, number of pleural passes, and technical success. Pair-wise comparisons of the remaining variables demonstrated a significant younger age and smaller needle size in the biopsy only group, and less minor complications in the fiducial only group. Overall there were 80/285 (28.1%) minor and 29/285 (10.2%) major complications. All major complications leading to admission consisted of either pneumothorax or hemothorax, while minor complications included asymptomatic stable or resolving pneumothoraces, transient hemoptysis or small hemothoraces. ConclusionsA combined procedure of percutaneous pulmonary core biopsy and stereotactic seed placement can be performed without additional risk of a major complication when compared to performing these separately.

Clinicopathological analysis of pulmonary marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue

背景与目的肺粘膜相关淋巴组织边缘区B细胞淋巴瘤（pulmonary marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, PMZL-MALT）极少见，易误诊。本文旨在总结该病特征，以提高临床医生的认识水平。方法回顾性分析四川大学华西医院2008年11月-2010年11月确诊的7例PMZL-MALT患者的临床病理资料。结果女性5例，男性2例；中位年龄62岁（37岁-74岁）。以咳嗽、咳痰为主要症状（6例）；CT多表现为肺部实变影（6例），误诊为肺炎。纤维支气管镜是主要的侵入性检查方法（6例）；7例患者肿瘤细胞免疫表型均为CD20和CD79a细胞膜弥漫强阳性表达，CD3ε、CD5、CyclinD1、CD10、Bcl-2和CD30不表达，Ki-67指数 < 10%；6例IgH基因重排分析可见克隆性条带。3例患者予以COP方案（环磷酰胺、长春新碱、泼尼松）化疗，其中1例加利妥昔单抗（RCOP）；1例予以CHOP方案（环磷酰胺、阿霉素、长春新碱、泼尼松）化疗；1例因糖尿病血糖控制不佳予以CTX（环磷酰胺）化疗；2例拒绝化疗。随访至2010年12月2日，仅1例既往有慢性阻塞性肺疾病史且未化疗者在确诊12个月后因呼吸衰竭死亡，其余患者的病情控制可。结论PMZL-MALT患者的临床表现无特异性，组织病理学检查是确诊的唯一手段，患者的预后较好。

Study on suceess rate of CT guided percutaneous pulmonary biopsy

Objective To discuss the technical factors of extrapleural locating in CT-guided percutaneous pulmonary biopsy. Methods 137 cases undervent CT-guided percutaneous pulmonary biopsy were retrospectively analyzed. The technical methods of operation,points and points for attention were analyzed. Results In this group the success rate of data manipulation was 98.5%. No serious complications of the operation were occured. Scan completed within 40-story biopsy rate was 71.5%. The needle into the target rate for the first time was 93.4%. Conclusion CT-guided biopsy could increase the detection rate of difficult lesions and patient satisfaction rate paying attention on thinking and practice in the preoperative preparation and intraoperative specific operations. Key words: Biopsy, needle; Tomograpluy, X-Ray,computed

Utility of computed tomography (CT) and of fine needle aspiration biopsy (FNAB) in early diagnosis of fungal pulmonary infections. Study of infections from filamentous fungi in haematologically immunodeficient patients

The purpose of this study was to evaluate the sensitivity of percutaneous computed tomography (CT)-guided lung biopsy in the early diagnosis of fungal pulmonary infections. Between 1997 and 2003, 18 haematologically immunodeficient patients with suspected filamentous fungi infection and negative bronchoalveolar lavage (BAL) underwent percutaneous pulmonary biopsy to diagnose the nature of the infection. In all cases, infection developed during the post-chemotherapy bone marrow aplasia period. Thirteen out of 18 patients had histologic findings positive for fungal infection: 8 Aspergillus and 5 Mucor. In 3 cases, biopsy was not specific, and in one case, the tissue sample was inadequate for a diagnosis; however, clinical course and response to drugs were compatible with fungal infection. In one patient, biopsy was positive for bronchoalveolar carcinoma. The sensitivity of percutaneous CT-guided biopsy was 80% and its positive predictive value was 100%. We only had one pneumothorax as a complication. Percutaneous CT-guided lung biopsy is an easy, safe and reliable procedure to obtain diagnostic material. Histological discrimination between Aspergillus and Mucor is important in order to plan the correct therapeutic protocols, as Mucor is usually resistant to azoles.

Guidance of percutaneous pulmonary biopsies with real-time CT fluoroscopy

Objective: Clinical evaluation of computed tomography (CT) fluoroscopy and comparison with conventional CT guidance for monitoring of percutaneous pulmonary biopsy procedures. Methods: Twenty CT-guided pulmonary biopsy procedures were conducted. The interventions have prospectively been performed either with CT fluoroscopy or with conventional CT guidance. About 120 kV and 50 mA with a frame-rate of eight images per second were used for CT fluoroscopy. Number of pleural needle passages, procedure times, radiation doses and histologic results were analyzed separately for both methods. Results: Compared with conventional CT guidance, CT fluoroscopy was associated with less pleural needle passages (1.8±0.6 vs. 1.1±0.3; P=0.003, t-test) and procedure times were shorter than for conventional CT guidance (12.7±2.2 min vs. 26.7±16.4 min; P=0.02). Analysis of estimated patient related radiation exposure and histologic outcome showed no significant difference between conventional and fluoroscopic CT-guided procedures ( P>0.05). Conclusion: CT fluoroscopy facilitates guidance of percutaneous pulmonary biopsy procedures. Compared with conventional CT assistance, procedure times are decreased and less pleural needle passages are required. While patient-related radiation exposure is similar, operator-related radiation exposure remains a disadvantage associated with CT fluoroscopy.

Percutaneous Pulmonary Endoarterial Biopsy in an Experimental Model of Pulmonary Hypertension

The aims of this study were: to evaluate the performance of a novel arterial biopsy catheter in obtaining pulmonary endovascular samples in hypertensive dogs; to compare the results of pulmonary endoarterial biopsy in hypertensive vs normotensive dogs; and to assess the histologic changes in the hypertensive model. Thirty-four dogs (27 with normal pulmonary arterial pressures and seven with pulmonary hypertension) were catheterized through an external jugular vein to obtain endovascular biopsy samples from distal pulmonary arteries 2 to 3 mm in luminal diameter. To induce pulmonary hypertension, seven dogs were given repeated infusions of 0.6- to 0.9-mm ceramic microspheres into the superior vena cava. Endoarterial samples were obtained at pulmonary systolic arterial pressures ranging from 10 to 110 mm Hg. Sixty-two biopsy catheterization procedures were performed in the 34 dogs. After 12 initial procedures of technique refinement, endoarterial samples were obtained in each of the last 50 procedures (21 in normotensive dogs and 29 in hypertensive dogs). The average number of endovascular biopsy samples retrieved was 7.1 (range, 2 to 12) from a mean of 8.6 (range, 2 to 15) biopsy attempts per catheterization (success rate=83%). The average biopsy piece measured 1.13 mm in length, 0.33 mm in depth, and up to 1.0 mm in width. The biopsy success rates and endoarterial sample sizes were similar in normotensive and hypertensive dogs. Smooth muscle cells and endothelial cells were grown from the biopsy samples. There were no significant procedural complications, except for one self-limited hemorrhage. Histologically, samples obtained from dogs with pulmonary hypertension showed characteristic changes when compared with biopsies from normotensive dogs. This new endoarterial biopsy catheter was safe and effective when used to obtain pulmonary endoarterial samples in dogs with normal and experimentally elevated pulmonary arterial pressures. The quality and quantity of the biopsy samples allowed identification of pathologic changes.

Percutaneous pulmonary biopsy in the diagnosis of lung cancer: Echegoyen CR, Medina MF, Rebora TF, Morales FJ, Leon PF, Chavarria GJ et al. Bulgaria, 88. Col. Portales, Mexico D.F.C.P. 03300. Neoplasia 1995;12:51–54

Percutaneous pulmonary biopsy in the diagnosis of lung cancer: Echegoyen CR, Medina MF, Rebora TF, Morales FJ, Leon PF, Chavarria GJ et al. Bulgaria, 88. Col. Portales, Mexico D.F.C.P. 03300. Neoplasia 1995;12:51–54

Thoracic drainage tubes

The invasive procedures handled by the pulmonologist in the diagnosis of lung disease have greatly expanded over the last decade (transbronchial, percutaneous or thoracoscopic pulmonary biopsy and needle aspiration). The growing number of intensive care units with facilities in mechanical ventilation and hemodynamic support has also modified the approach of the critically ill patient. Pneumothorax and hemothorax are well-known complications related to these diagnostic and therapeutic techniques. Other areas of interest and up-to-date are diagnostic thoracoscopy in pleural disease, chemical pleurodesis in patients with pneumothorax or malignant pleural effusion, and the administration of intrapleural fibrinolytics in the treatment of empyema. This evolution implicates that the pulmonologist and the intensivist be skilled in the management of chest tubes. In this article we review the indications, some technical topics and the principal complications related to the placement of thoracic drains.

Percutaneous pulmonary needle biopsy. Report of 350 patients.

Percutaneous needle aspiration biopsy of pulmonary lesions is a simple, safe, practical, and acceptable diagnostic procedure. The diagnostic yield of this procedure exceeds that of any other method, other than open thoracotomy. With the use of No. 16 or No. 18 thin-walled needles, image amplifier guidance, and needle guidance instruments, all lesions, either in central or peripheral portions of the lung, are accessible for biopsy.Four hundred and ten needle aspiration biopsies were carried out on 350 patients. Of 290 confirmed cases, 190 were proven to be malignant by needle biopsy and 44 were proven to be benign. Two hundred and thirty-four patients out of 290 were diagnosed by needle biopsy—a biopsy success rate of 81 per cent. A second or third biopsy will significantly increase the number of satisfactory biopsies. The complications of a pneumothorax are of no consequence and can be immediately handled by the radiologist using a pneumothorax catheter. Other complications of subcutaneous emphysema, hemo...

Aspiration Biopsy in Diagnosis of Pulmonary Nodule

Percutaneous pulmonary biopsy is a direct approach to diagnosis of the troublesome pulmonary nodule. Our series emphasizes the accuracy and simplicity of the technique with 124 positive cases of carcinoma diagnosed without a serious complication. Specific cell type was given in 105 of the 124 cases of carcinoma. Valuable diagnostic information leading to the diagnosis of benign conditions was obtained in 14 cases. The procedure can be utilized on an outpatient basis and can save valuable time and permit prompt institution of appropriate therapy. Percutaneous pulmonary biopsy is a direct approach to diagnosis of the troublesome pulmonary nodule. Our series emphasizes the accuracy and simplicity of the technique with 124 positive cases of carcinoma diagnosed without a serious complication. Specific cell type was given in 105 of the 124 cases of carcinoma. Valuable diagnostic information leading to the diagnosis of benign conditions was obtained in 14 cases. The procedure can be utilized on an outpatient basis and can save valuable time and permit prompt institution of appropriate therapy.