Diagnostic Value of Transthoracic Fine Needle Aspiration Biopsy in Thoracic Lesions

Transthoracic fine needle aspiration biopsy (TFNAB) is a fre­quently used method that has low complication rate. In this study, we investigated the accuracy and complication rate of TFNAB which we have performed in 102 patients with negative sputum cytology and negative bronchoscopic examinations for the tho­racic mass lesions.Of these patients hospitalized in our hospital between March 1995 and December 1997, 86 of them were male, 16 of them were female, and their mean age was 50±6.5 years. The same process was performed in 15 patients for two times, and in 5 patients for three times. Totally 127 procedures were performed; 55 by com­puterized tomography, 45 by ultrasonography, and 27 by fluo­roscopy.In 60 of the total 102, malignancy and in 39 of them cytologic findings suggesting benignity were obtained. In three cases, suffi­cient diagnostic specimen could not be obtained. Of the 102 cases, malignancy in 67, and benignity in 35 were confirmed by histological, microbiological, clinical and/or radiological follow­up. In the 4 of the 6 cases that were diagnosed as benign by TFNAB, surgical, and in 2 of them clinical and radiological diag­nosis were made; these 6 cases and one with insufficient specimen were considered as false negative cases. While the diagnostic value of the process in all the thoracic lesions was found as 70.58%, in malignant lesions the sensitivity was 89.55%, speci­ficity was 100% and accuracy was 91%. The diagnostic value in benign lesions was low. Specific diagnosis could be established in only 12 (34%) of the benign lesions. The most frequent compli­cation was pneumothorax and was seen in 10 cases (9.8%), and chest tube was needed in only 4 of them. Other complications were hemoptysis in 9 cases and hemorrhage in one. We concluded that TFNAB is a safe and easily applied method especially valu­able in the diagnosis of malignant lesions.