NEEDLE ASPIRATION BIOPSY OF MALIGNANT LUNG MASSES WITH NECROTIC CENTERS - IMPROVED SENSITIVITY WITH ULTRASONIC GUIDANCE

False-negative results from transthoracic needle aspiration biopsy of malignant lung masses may occur if a central necrotic area is present and is the source of the biopsy material. The purpose of this study is to determine if the use of ultrasonic guidance can improve the sensit ivity of lung needle biopsies in this circumstance. Sixty patients wit h malignant lung masses underwent ultrasonic examination in an 18-mont h period. In 14 cases, ultrasound showed that the mass had a large cen tral necrotic area that was at least half the diameter of the tumor. U nder ultrasonic guidance, needle biopsy specimens were taken from the central necrotic area and from the tumor wall in each case. Adequate b iopsy specimens were obtained in all 14 patients. In all cases, the mu ral biopsy material was diagnostic for malignant tumor, while the biop sy specimen from the necrotic center was nondiagnostic in 10 of 14 pat ients. No complications occurred. We conclude that ultrasonically guid ed lung biopsy is a useful and safe tool to avoid false-negative needl e biopsy specimens in malignant lung tumors with necrotic centers.