Cutting needle biopsy in the diagnosis of clinically suspected non-carcinomatous disease of the lung

Most patients referred fbr lung biopsy have a focal lesion that is likely t o be a carcinoma, and fine needle aspiration is usually sufficient to confi rm the diagnosis. When noncarcinomatous disease is suspected, tissue archit ecture is important and potential diagnostic techniques include percutaneou s cutting needle biopsy (CNB). We retrospectively reviewed 37 CNBs performe d for clinically suspected non-carcinomatous disease; recording the biopsy result, final diagnosis, radiological nature of the pulmonary abnormality, distance from the pleura of the lesion biopsied and biopsy complications. 9 patients had a single pulmonary nodule/mass; 13 had multiple nodules/masse s; 8 had a lobar consolidation/mass; and 7 had multifocal consolidation. Th e lesion abutted the pleura in 31 cases, lying within 1 cm in the other 6 c ases. The minor complication rate was 14%, with no major complications. Spe cific malignant diagnoses were made in 9 patients, and specific benign in 2 3, in all of whom clinicoradiological follow-up was concordant. CNB did not yield a specific diagnosis in five patients, including two lymphomas and o ne case of unsuspected tuberculosis in which the sample was not cultured. T he overall accuracy of CNB was 32/37 (86%). CNB is a safe and accurate mean s of achieving a tissue diagnosis for patients with peripheral pulmonary pa renchymal disease thought not to represent carcinoma.