Efficient and safe method in the diagnosis of thoracic lesions: ultrasound-guided needle aspiration biopsy

Abstract

Background: this study aimed to investigate the diagnostic value of fine-needle aspiration biopsy (FNAB) performed under the guidance of thoracic ultrasonography (USG) for the diagnosis of thoracic lesions such as peripheral lung lesions, pleural lesions, mediastinal lesions, and chest wall or supraclavicular metastases of lung lesions. Material and methods: cases with thoracic lesions that were found eligible for biopsy by thoracic USG and underwent FNAB between January 2008 and December 2016 were included in the study. Demographical characteristics and radiological findings of the cases, lesion size as detected by USG, sonographic patterns, number of FNABs per lesion, diagnosis based on FNAB, final diagnosis of inconclusive cases and the methods used to establish the final diagnosis, and developed complications were recorded. Results: FNAB was performed for peripheral lung lesion in 188 (72.6%), mediastinal mass in 23 (8.9%), chest wall metastasis of lung tumor in 23 (8.9%), supraclavicular lymph node metastasis of lung tumor in 18 (6.9%), and pleural lesion in 7 (2.7%) cases. The corresponding diagnostic accuracy was 78.7%, 78.2%, 95.6%, 94.4% and 85.7%, respectively. A diagnosis could be made in 211 (81.4%) of 259 cases (195 [92.4%] malignant and 16 [7.6%] benign). The overall diagnostic success of the procedure was 81.4%, and the success rate to diagnose malignant and benign lesions was 81.9% and 76.1%, respectively. Pneumothorax which needs pleural tube in placement was seen in five patients, with peripheral lesion as the major complication. Conclusion: USG-guided FNAB performed for thoracic lesions is associated with a high rate of diagnostic success (81.4%) and a low rate of major complications (1.9%).