INTRAPULMONARY LESIONS - PERCUTANEOUS AUTOMATED BIOPSY WITH A DETACHABLE, 18-GAUGE, COAXIAL CUTTING NEEDLE

PURPOSE: To evaluate a lung biopsy technique in which a detachable, 18 -gauge, coaxial guide around a central notched stylet is used as a cut ting needle. MATERIALS AND METHODS: The records of 89 consecutive pati ents (41 women, 48 men; aged 21-86 years) who underwent coaxial percut aneous core biopsy of 91 lung lesions that required needle passage thr ough normal lung tissue (mean lesion size, 33.6 mm; range, 9-80 mm) we re studied. Detachable, 18-guage, coaxial automated cutting needles we re used. RESULTS: The mean number of needle passes was 2.5 (range, 1-4 ). All biopsies yielded sufficient tissue for histopathologic (n = 91) and, if necessary, bacteriologic (n = 12) evaluation (mean core lengt h, 5 mm; range, 1-15 mm). Eighty-nine lesions had definitive diagnosis . Seventy-five lesions were proved to be malignant; seventy (93%) coul d be accurately diagnosed with coaxial percutaneous core biopsy sample s. Fourteen lesions were proved to be benign; 10 (71%) were specifical ly diagnosed with biopsy samples. Among the 91 biopsies, the overall d iagnostic accuracy was 88% (80 of 91 lesions). A pneumothorax occurred in 31 cases (34%), three (3%) of which necessitated placement of a ch est tube. Postbiopsy hemoptysis occurred and resolved spontaneously in nine cases (10%). CONCLUSION: This technique provides a core biopsy s pecimen without the need for an on-site cytopathologist during the pro cedure. It has a high diagnostic accuracy and an acceptable rate of co mplications.