VALUE OF CT-GUIDED FINE-NEEDLE ASPIRATION IN SOLITARY PULMONARY NODULES WITH NEGATIVE FIBEROPTIC BRONCHOSCOPY

The usefulness of fine needle aspiration (FNA) with CT-guidance was ev aluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were ana lyzed for all patients with SPN who had undergone chest FNA in the yea rs 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscop y. A final diagnosis was made by biopsy (transbronchial, thoracotomy o r necropsy), response to therapy or follow-up of the lesions. The pati ents had medium-sized lesions, 2.87+/-1.11 cm, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100 % specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontane ously, and 12 cases of pneumothorax; requiring a thoracic tube in 4 pa tients, were noted.