Percutaneous Image-Guided Cutting Needle Biopsy of the Pleura in the Diagnosis of Malignant Mesothelioma
| Autor: | R F Adams, Winifred Gray, Robert J. O. Davies, Fergus V. Gleeson |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Mesothelioma Pulmonary and Respiratory Medicine medicine.medical_specialty Percutaneous Pleural Neoplasms Critical Care and Intensive Care Medicine Pleural disease Hematoma Predictive Value of Tests Biopsy Biomarkers Tumor Thoracoscopy medicine Humans Aged Retrospective Studies Ultrasonography Aged 80 and over medicine.diagnostic_test business.industry Biopsy Needle Respiratory disease Equipment Design Middle Aged respiratory system medicine.disease respiratory tract diseases Fine-needle aspiration Surgery Computer-Assisted Pleura Female Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest. 120:1798-1802 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.120.6.1798 |
| Popis: | Study objectives: Pleural fluid cytology and non–image-guided Abrams or Cope biopsies have sensitivities of approximately 30% for detecting malignant mesothelioma, and thoracoscopic biopsy has a sensitivity of approximately 90%. The difference between these two probably relates to obtaining adequate tissue. The use of immunohistochemical stains allows a firm diagnosis to be made from relatively small samples. This study explores whether percutaneous image-guided cutting needle biopsy (CNB) combined with immunohistochemistry is accurate in diagnosing pleural thickening due to mesothelioma. Design: Retrospective review of image-guided CNB of pleural thickening performed on consecutive patients over 7 years by a single radiologist. Setting: Teaching hospital chest radiology department. Patients: Twenty-one adult patients with a final diagnosis of malignant mesothelioma were identified from 53 consecutive patients who underwent percutaneous image-guided CNB. All 21 patients had pleural thickening identified on contrast-enhanced CT, and all had a final histologic diagnosis of mesothelioma confirmed by postmortem examination or thoracoscopy. Interventions: Fourteen-gauge and 18-gauge cutting needles were used. Biopsy guidance was by ultrasound in 6 patients and by CT in 15 patients. Measurements and results: A correct histologic diagnosis of malignant mesothelioma was made by CNB in 18 patients (86% sensitivity and 100% specificity). Complications included one chest wall hematoma and a small hemoptysis. Four patients with a pleural thickness of < 5 mm underwent biopsy, and all specimens were diagnostic for mesothelioma. Conclusions: Image-guided percutaneous CNB of pleural thickening is a safe procedure, with 86% sensitivity for detecting malignant mesothelioma. Pleural thickening of < 5 mm may be successfully sampled. (CHEST 2001; 120:1798 –1802) |
| Databáze: | OpenAIRE |
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