PERCUTANEOUS CORE CUTTING NEEDLE-BIOPSY COMPARED WITH FINE-NEEDLE ASPIRATION IN THE DIAGNOSIS OF PERIPHERAL LUNG MALIGNANT LESIONS - RESULTS IN 156 PATIENTS

BACKGROUND. The authors attempted to determine the utility of percutan eous core needle biopsy (PCNB) compared with fine-needle aspiration (F NA) in the diagnosis of peripheral lung carcinoma. METHODS. A retrospe ctive review was undertaken of 156 computed tomography (CT)-guided PCN Bs and FNAs of malignant lung lesions between 1988-1996. Both CT-guide d FNA and PCNB biopsies were performed sequentially at the same visit for each subject. RESULTS. The authors reviewed 156 malignant lesions whose specific diagnosis was obtained by FNA in 133 cases (85.3%) and by PCNB in 121 cases (77.6 %) (P < 0.05). PCNB confirmed the FNA diagn osis in 90 patients (57.7 %), provided additional information in 17 pa tients (10.9%), and was less informative than FNA in 35 patients (22.4 %), mostly those with nonsmall cell carcinoma. The PCNB was marginally superior to FNA only in cases of metastatic carcinoma. The only signi ficant complication encountered was a 24% rate of pneumothorax, which is comparable to the reported rate for FNA alone-induced complications . CONCLUSIONS. PCNB offers no substantial advantage over FNA in the ev aluation of peripheral malignant lung lesions. Therefore, the authors recommend the use of FNA biopsy as the initial diagnostic procedure in all cases of suspected malignancy. The use of the PCNB technique is r ecommended when the diagnosis of malignancy by FNA is uncertain, or wh en a more detailed characterization of the lesion is required. (C) 199 8 American Cancer Society.