PROTECTIVE PNEUMOTHORAX IN CT MONITORED M EDIASTINAL PUNCTURE

Purpose: To achieve an extrapulmonary pathway for biopsy of mediastina l masses. Methods: In 6 patients a protective, temporary pneumothorax was established before performing large-bore needle biopsies of medias tinal masses using a Verres-needle. Results: Transpleural, extrapulmon ary access was easy to achieve. One patient developed a tension pneumo thorax after biopsy which was drained by percutaneous small chest tube . Another patient showed mediastinal tumour bleeding through the biops y needle. As a prophylactic measure the bleeding was stopped by inject ion of tissue glue through the biopsy needle. Conclusion: The use of p rotective pneumothorax allows cutting needle biopsies of mediastinal m asses where aspiration cytology yields no secure specific diagnosis.