Direct percutaneous needle aspiration of localized pulmonary lesions: result in 422 patients.

Abstract

Diagnostic needle aspiration of 400 (293 malignant and 107 benign) pulmonary lesions was performed with 20-gauge needles. Deep and peripheral nodules and masses were routinely biopsied. Positive diagnostic accuracy was 96.5%. There were 9 (2%) incorrect diagnoses with 5 false-negatives and 4 false-positives. In almost all patients with malignant pulmonary neoplasms, the specific cell type was identifiable. Pneumothorax was a frequent complication, but there were no fatalities or episodes of major bleeding or hemoptysis. A new slotted 20-gauge thin-wall needle was used in 258 patients. This enabled aspiration of larger amounts of material than was possible with the standard 20-gauge thin-wall needle, and in approximately 50% of patients, enough material was obtained to perform tissue sections and smears for cytology. In 77 patients with benign lesions and in 114 with unresectable neoplasms, needle aspiration established the diagnosis and made it unnecessary to perform surgery and/or mediastinoscopy.