PERCUTANEOUS TRANSTHORACIC NEEDLE-BIOPSY OF THE LUNG - REVIEW OF 612 LESIONS

PURPOSE: The results and complications of 651 pulmonary fine-needle as piration biopsies (FNABs) were reviewed. The number of needle passes a nd needle size were correlated to pneumothorax and chest tube placemen t rates. MATERIALS AND METHODS: FNAB of the lung was performed on 651 occasions in 612 patients with 18- to 22-gauge Franseen needles. Diagn ostic rates were calculated, The number of needle passes performed and needle size used were evaluated for their association with pneumothor ax and subsequent chest tube placement. RESULTS: Diagnostic accuracy w as 94% with sensitivity for malignancy of 95%. Positive and negative p redictive values were 99.5% and 90%, respectively, Pneumothorax occurr ed in 26.9% of patients with 9.2% requiring chest tube placement. Incr easing numbers of needle passes and larger needle sizes did not increa se the rates of pneumothorax or chest tube placement. CONCLUSIONS: FNA B of the lung has excellent diagnostic rates and remains the procedure of choice for diagnosing pulmonary lesions. This large study contradi cts perceptions that pneumothorax and chest tube placement rates decre ase with thinner needles and fewer passes.