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CT-guided Biopsy of Nonresolving Focal Air Space Consolidation

Ferretti, Gilbert R. MD, PhD*; Jankowski, Adrien MD; Rodière, Mathieu MD; Brichon, Pierre Yves MD, PhD; Brambilla, Christian MD§; Lantuejoul, Sylvie MD, PhD

doi: 10.1097/RTI.0b013e3181453e04
Original Articles

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:

© 2008 Lippincott Williams & Wilkins, Inc.