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Background: Transthoracic needle biopsy is a well established
method for obtaining pathologic diagnosis in the lung mass that performed after
a previous negative bronocoscopy. The goal of this study is evaluation of the
safety and accuracy of ultrasonographic guided transthoracic needle biopsy for
diagnosing peripheral lung mass.
Methods: In a descriptive and prospective study from
September 2005, 30 patients with peripheral lung mass with greater
than 3cm in diameter and less than 5cm
distance through the chest wall, underwent ultrasonographic guided transthoracic
needle biopsy and it's diagnostic accuracy and complications were analyzed.
Results: The male to female ratio was two to one, the average
age of the patients was 61.2 years and 60% of
the lesions were located in right side. Adequate biopsy specimens were obtained
in all patients, but transthoracic needle biopsy was diagnostic in 86.6% and 13.3% patients because doubtful diagnosis, who
underwent thoracotomy for definitive diagnosis. From these four (13%) patient who needed thoracotomy definitive diagnosis were organized
embolism, granulomatouse tuberculosis, bronchoalveolar carcinoma, and
metastatic adenocarsinoma. Pathological diagnosis were malignant lesion in 83.3% that squamouse cell carcinoma and adenocarcinoma were the most common
malignancies and benign lesions were found in 16.6%
that granulomatouse tuberculosis was the most common lesion. Complications were
observed in 13.3% that included pneumothorax (6.6%) and hemoptysis (6.6%) that managed medically. No cases of mortality
were observed.
Conclusion: Transthoracic needle biopsy with ultrasonographic
guide due to appropriale diagnostic accuracy and low complication rate with low
cost and availability is recommended for the diagnosis of peripheral lung mass.
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