UTILITY OF INTRAOPERATIVE FINE-NEEDLE ASPIRATION BIOPSY IN THE SURGICAL-MANAGEMENT OF PATIENTS WITH PULMONARY MASSES

Sporadic reports have postulated that intraoperative fine needle aspir ation biopsy (FNAB) is a useful adjunct in the surgical management of patients with pulmonary masses. We reviewed 38 consecutive intraoperat ive pulmonary FNABs performed at our institution in order to assess th e efficacy of this technique, as measured by (1) its sensitivity, spec ificity, predictive values and concordance rates, and (2) the appropri ateness of the resultant surgical therapy. Six cases were benign (16%) and 32 malignant (84%); none were small cell carcinomas. Aspirates fr om the six benign lesions were designated either benign or nondiagnost ic; there were no false-positive diagnoses (specificity = 100%). Aspir ates from 30 of the 32 malignant neoplasms were diagnosed as malignant , one was considered suspicious for carcinoma, and one was interpreted as benign (sensitivity = 97%). The positive and negative predictive v alues were 100% and 86%, respectively. The concordance rate for benign ancy/malignancy between the intraoperative FNAB interpretation and fin al diagnosis was 97%. The intraoperative FNAB diagnosis contributed to less-than-optimal surgical therapy in only one case. Thus, we conclud e that intraoperative pulmonary FNAB has utility in the proper surgica l management of pulmonary masses.