PERCUTANEOUS NEEDLE-BIOPSY OF LOCALIZED PULMONARY, MEDIASTINAL, AND PLEURAL DISEASED TISSUE WITH AN AUTOMATIC DISPOSABLE GUILLOTINE SOFT-TISSUE NEEDLE - PRELIMINARY-RESULTS

Percutaneous needle biopsy (PNB) of localized thoracic disease has bec ome a widespread procedure in many institutions. The development of sp ecial small caliber needles has increased the diagnostic yield of PNB partly by increasing the amount of tissue from biopsy, often enabling histologic examination. Nevertheless, in a significant number of patie nts only cytopathologic examination is possible on the retrieved biops y fragments, necessitating the presence of a trained cytopathologist i n the biopsy room. Furthermore multiple biopsy needle passages often a re required, increasing the risk for complications such as pneumothora x. We have evaluated the use of a small-caliber tissue biopsy cutting needle, consistently yielding sufficient biopsy tissue for histologic examination. In 25 pleural and mediastinal lesions, which could be bio psied without passage through aerated lung, there was a 93% sensitivit y (7% false-negative results) for neoplasm and a 100% accuracy for ben ign disease. There were no complications. In 32 patients with lesions of 1 cm in diameter or more surrounded with aerated lung tissue, adequ ate histologic examination was feasible on every biopsy specimen after only one needle passage. There was an 87% sensitivity of PNB in neopl astic disease (13% false-negatives). In the patients with benign disea se, there was a 100% accuracy. There was a 15.6% risk for pneumothorax . In only one patient (3%), however, was chest drainage necessary. One patient (3%) had mild hemoptysis. We conclude that percutaneous biops y of localized pulmonary, pleural, and mediastinal lesions with a new small-caliber automatic guillotine cutting needle is safe and efficien t, enabling recovery of sufficient tissue for histologic examination w ith a single-pass procedure, thus minimizing the risk for pneumothorax , eliminating the need for a cytopathologist in the biopsy room, and s hortening the duration of the procedure.