Computed tomography-guided fine needle aspiration of peripheral lung opacities - An initial diagnostic procedure?

OBJECTIVE: To evaluate the results of computed tomography (CT)-guided fine needle aspiration (FNA) cytology following negative fiberoptic bronchoscopy and sputum cytology. STUDY DESIGN: Retrospective study of 64 patients who underwent CT-guided ne edle aspiration of lung opacities otter one year. Following a re review of the CT studies, patients were selected according to image characteristics o f a primary neoplasm and pleural effusion in eases with pleural lesions. Th e lesions were classified into three categories-intrapulmonary and peripher al pulmonary pleuropulmonary and pleural-and were localized and aspirated u nder CT using a fine needle (22-23 gauge)for obtaining cellular material. L esions diagnosed as benign on FNA cytology were followed by serial CT scans for a period of two years at sis-month intervals. RESULTS: Thirty-nine of 64 (61%) lesions were diagnosed as malignant on FNA cytology and 25 of 64 (39%) as benign. There was one false negative case. There were no serious complications from the procedure. CONCLUSION: FNA tinder CT guidance may be applied as the initial procedure in the diagnosis of peripheral malignant pulmonary lesions, rendering a hig h diagnostic yield.