Objectives: To evaluate the diagnostic accuracy of percutaneous computed tomography (CT)-guided coaxial core needle biopsy in patients with nonresolving pulmonary focal air space consolidations and negative fiberoptic bronchoscopy results.
Methods: From 1997 to 2005, 23 patients (11 woman, 12 men; age range, 45 to 81 y; mean age, 66 y) presenting with nonresolving pneumonia persisting more than 8 weeks (mean, 22 wk; range, 8 to 40 wk) with negative fiberscopic results, underwent coaxial percutaneous biopsy using an automated core needle (18-gauge) under CT guidance. Histologic and bacteriologic evaluations were obtained. The final diagnosis was confirmed by surgical pathology, culture results, or clinical follow-up.
Results: Specimens adequate for histopathologic evaluations were obtained in 20 (87%) cases. Final diagnoses were lung cancer (n=15) and benign diseases (infectious pneumonia, 3; lipoid pneumonia, 1; Erdheim Chester disease: 1; and nonspecific chronic pneumonia, 3). Diagnostic yield of core needle biopsy was 78% (18 of 23). The sensitivity and specificity for malignancy were 87% and 100%, respectively. Immediate pneumothorax was present in 11 patients of cases, but only 2 patients required pleural drainage.
Discussion: CT-guided lung biopsy using a core needle biopsy provides a high degree of diagnostic accuracy and allows specific characterization of nonresolving pulmonary focal air space consolidation.
*Service Central de Radiologie et Imagerie Médicale
‡Département de Chriurgie Thoracique et Vasculaire
∥Département de Pathologie Cellulaire, INSERM U 823
†Service Central de Radiologie et Imagerie Médicale, CHU Grenoble
§INSERM U 823, Institut A Bonniot, Grenoble, France
The work was performed at the Centre Hospitalier Universitaire de Grenoble, France with the financial help of PHRC National-2003- (“Microméthodes et analyses moléculaires pour le diagnostic des tumeurs malignes humaines”).
Reprints: Gilbert R. Ferretti, MD, PhD, Service Central de Radiologie et Imagerie Médicale, CHU Grenoble BP 217, F-38043 Grenoble cedex 09, France (e-mail: firstname.lastname@example.org).