VALUE OF ULTRASONICALLY GUIDED NEEDLE-BIOPSY OF PLEURAL MASSES - AN UNDER-UTILIZED TECHNIQUE

Thirty-six patients with pleural masses underwent ultrasonically guide d needle biopsy (UGNB), including ultrasonically guided aspiration bio psy (UGAB) in all 36 patients and ultrasonically guided cutting biopsy (UGCB) in 13 patients. Using UGAB alone, the diagnostic rate for pleu ral masses was 64% (23/36); carcinomatous pleural masses were more eas ily diagnosed than non-carcinomatous pleural masses (87% vs 23%, p < 0 .01). If both UGAB and UGCB were used, the diagnostic rate was 89% (32 /36); thus, selective UGCB was valuable in improving the diagnostic ra te of non-carcinomatous pleural masses (from 23% to 69%). In patients with pleural effusions (n = 19), 11 underwent cytologic examinations o f the pleural effusion (3 also undergoing pleural biopsy) without conc lusive diagnosis; however, the diagnosis was made from pleural masses by UGAB (n = 7) or UGCB (n = 4). In patients without pleural effusions (n = 17), 12 had only pleural masses (3 also having multiple peripher al pulmonary nodules and 4 having mediastinal tumors) and could not be diagnosed by conventional bronchoscopic and sputum examinations. Howe ver, the diagnosis was rapidly confirmed by UGAB (n = 5) or UGCB (n = 3) from the pleural masses in 8 patients. We conclude that UGNB is a u seful and valuable diagnostic tool, not only detecting the pleural mas ses hidden by pleural effusions but also for rapidly diagnosing the pl eural masses. (C) 1997 John Wiley & Sons, Inc.