CT-GUIDED BIOPSY OF PULMONARY NODULES LESS-THAN 3 CM - USEFULNESS OF THE SPRING-OPERATED CORE BIOPSY NEEDLE AND FROZEN-SECTION PATHOLOGICALDIAGNOSIS

OBJECTIVE, The purpose of this study was to improve the diagnostic acc uracy of CT-guided biopsy of small lung nodules with the aid of frozen -section histopathologic diagnosis. SUBJECTS AND METHODS. Since 1993, we have evaluated 52 lung nodules smaller than 3 cm with CT-guided tra nsthoracic biopsy, Thirty-five lesions were malignant and 17 were beni gn. Biopsy always started with a 20-gauge spring-operated core biopsy needle. Tissue samples were sent to the pathology laboratory immediate ly after biopsy for histopathologic diagnosis of the frozen sections. RESULTS, In 47 (90%) of 52 lesions, sufficient material for histologic diagnosis was obtained, including 34 (97%) of 35 malignant lesions an d 13 (76%) of 17 benign lesions. In the 13 benign lesions for which hi stologic sampling was successful, a specific diagnosis of benign was m ade for 10 lesions (77%). In three cases, the sample was too small to make a histologic specimen, but cytologic study using the same sample led to the correct final diagnosis: one as malignant and two as benign . In the remaining two cases, biopsy was unsuccessful, The lesions wer e both 1 cm in size and were found to be benign on follow-up studies, CONCLUSION. CT-guided biopsy with the aid of frozen-section specimens using small-bore spring-operated core needles is a feasible technique with good results in the histologic diagnosis of small lung lesions.