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Guzinski M, Puła M, Zdanowicz A, Kacała A, Dudek K, Lipiński A, Sąsiadek M. Safety, feasibility, and effectiveness of a CT-guided transthoracic lung and pleural biopsy - a single-centre experience with own low-dose protocol. Pol J Radiol 2023; 88:e546-e551. [PMID: 38125814 PMCID: PMC10731440 DOI: 10.5114/pjr.2023.133309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/17/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose To assess the efficacy and safety of a low-dose, computed tomography (CT)-guided transthoracic biopsy of lung and pleural lesions. Material and methods A total of 135 low-dose, CT-guided transthoracic lung and pleural lesions biopsies were performed. A cutting needle was utilized in 124 cases, and fine needle aspiration biopsy was performed in 14 cases. In all cases, 14- to 22-gauge biopsy needles were used. Results Diagnostic material was obtained in 111 (82.2%) patients. In 97 (71.8%) cases neoplastic lesions were found, predominantly adenocarcinoma and non-small cell carcinoma. In 14 (12.6%) cases non atypical cells were reported. Biopsy failed to obtain material suitable for histopathological examination in 24 (17.7%) cases. Complications occurred in 31 patients, including pneumothorax in 28 patients and haematoma in 3 cases. Conclusions Based on the obtained results, it can be stated that low-dose, CT-guided transthoracic biopsy of lung and pleural tissues is an accurate and safe procedure. Also, it is linked to a low risk of complications such as a small pneumothorax.
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Affiliation(s)
- Maciej Guzinski
- Department of General Radiology, Interventional Radiology, and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Michał Puła
- Department of General Radiology, Interventional Radiology, and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Agata Zdanowicz
- Department of General Radiology, Interventional Radiology, and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Arkadiusz Kacała
- Department of General Radiology, Interventional Radiology, and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Krzysztof Dudek
- Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Artur Lipiński
- Department of Clinical Pathology, Wroclaw Medical University, Wrocław, Poland
| | - Marek Sąsiadek
- Department of General Radiology, Interventional Radiology, and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
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Fan P, Cao J, Jin Y, Han H, Wang W, Xu H, Ji Z. Efficacy of contrast-enhanced ultrasound-guided percutaneous core needle biopsy in anterior mediastinal masses. J Interv Med 2022; 5:159-165. [PMID: 36317148 PMCID: PMC9617154 DOI: 10.1016/j.jimed.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/15/2022] [Accepted: 04/16/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the efficacy and safety of percutaneous core needle biopsy (PCNB) using ultrasound (US)-guided and contrast-enhanced ultrasound (CEUS)-guided procedures for anterior mediastinal masses (AMMs). Methods In total, 284 consecutive patients (166 men, 118 women; mean age, 43.0 ± 18.4 years) who underwent PCNB for AMMs were enrolled. Patients were divided into the US-guided group (n = 133) and the CEUS-guided group (n = 151). PCNB was performed using a core needle (16-gauge or 18-gauge). Internal necrosis, diagnostic yield, and diagnostic accuracy were compared between the two groups. Results The predominant final diagnosis of the cases in this study was thymoma (29.7%), lymphoma (20.5%), thymic carcinoma (13.3%), and germ cell tumour (13.3%), respectively. There was no significant difference in patient age, sex, number of percutaneous biopsies, or display rate of internal necrosis on conventional US between the two groups. The rate of internal necrosis of the lesions was significantly higher after contrast agent injection (72.2% vs. 41.7%; P < 0.001). The CEUS-guided group had a higher diagnostic yield than the US-guided group (100% vs. 89.5%, P < 0.001). There was no significant difference between the diagnostic accuracy of the CEUS-guided and US-guided groups (97.3% vs. 97.4%; P = 1.000). None of the patients experienced adverse reactions or complications after US-guided or CEUS-guided PCNB. Conclusions CEUS-guided PCNB can improve the diagnostic yield by optimizing the biopsy procedure.
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Affiliation(s)
- Peili Fan
- Department of Ultrasound, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Institute of Ultrasound Medicine and Engineering, Fudan University, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China
| | - Jiaying Cao
- Department of Ultrasound, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Institute of Ultrasound Medicine and Engineering, Fudan University, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China
| | - Yunjie Jin
- Department of Ultrasound, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Institute of Ultrasound Medicine and Engineering, Fudan University, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China
| | - Hong Han
- Department of Ultrasound, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Institute of Ultrasound Medicine and Engineering, Fudan University, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China
| | - Wenping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Institute of Ultrasound Medicine and Engineering, Fudan University, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China
| | - Huixiong Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Institute of Ultrasound Medicine and Engineering, Fudan University, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China
| | - Zhengbiao Ji
- Department of Ultrasound, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, 200032, Shanghai, China
- Institute of Ultrasound Medicine and Engineering, Fudan University, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China
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3
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Navin PJ, Eickstaedt NL, Atwell TD, Young JR, Eiken PW, Welch BT, Schmitz JJ, Schmit GD, Johnson MP, Moynagh MR. Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy. Mayo Clin Proc Innov Qual Outcomes 2021; 5:1100-1108. [PMID: 34877475 PMCID: PMC8633817 DOI: 10.1016/j.mayocpiqo.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Objective To retrospectively evaluate the safety and efficacy of percutaneous image-guided mediastinal mass core-needle biopsy. Patients and Methods Retrospective review of an institutionally maintained biopsy registry identified 337 computed tomography- or ultrasound-guided percutaneous mediastinal mass core needle biopsies between October 2002 and August 2017 in a single quaternary referral center. Mean patient age was 51 (range, 18 to 93) years. Procedural techniques, anticoagulation/antiplatelet therapy, and tumor anatomical characteristics were reviewed. Classification and gradation of complications was based on the Clavien-Dindo system. Diagnostic yield was defined as the ratio of diagnostic biopsy to all biopsies performed. Results Mean tumor size was 59.2 (range, 10 to 180) mm with 89.9% (n=303) of lesions located in the prevascular (anterior) mediastinum. There was a single major complication (0.3%) of a symptomatic pneumothorax requiring intervention. There were seven (2.1%) minor complications, including three bleeding complications. A transpleural approach was the only variable associated with an increased complication rate (P<.01). Forty-one (12.2%) patients had a biopsy performed while taking an antiplatelet/anticoagulant agent within the therapeutic window, with a single case (0.3%) associated with a minor bleeding complication. Of 18 (5.3%) procedures performed without cessation of anticoagulant/antiplatelet therapy, there were no bleeding complications. Of all 337 biopsies, 322 (95.5%) were diagnostic. None of the analyzed variables were significantly associated with a nondiagnostic biopsy. Conclusion Image-guided percutaneous core-needle biopsy of mediastinal masses is a safe procedure with high diagnostic yield. Further prospective studies are required to assess the complication profile in higher risk patients.
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Araki T, Kobayashi T, Kobayashi S, Sonehara K, Tateishi K, Kanda S, Hanaoka M, Koizumi T. Thymic epithelial tumor with superior vena cava syndrome diagnosed by percutaneous endovascular tumor biopsy: A report of two cases. Respir Investig 2021; 59:695-699. [PMID: 33975817 DOI: 10.1016/j.resinv.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Abstract
Thymic epithelial tumor is a rare, potentially progressive disease that commonly infiltrates mediastinal structures. In rare cases, it may cause superior vena cava syndrome. Pretreatment histopathological diagnosis is essential to determine the most effective treatment strategy. Percutaneous endovascular biopsy is a rarely reported non-surgical diagnostic option for large vessel tumoral involvement. We report two cases of thymic epithelial tumor with superior vena cava syndrome diagnosed by percutaneous endovascular biopsy. No procedural complications occurred, and subsequent systemic treatment was promptly administered. This procedure may have potential as a useful diagnostic method for patients with mediastinal tumors involving large vessels.
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Affiliation(s)
- Taisuke Araki
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
| | - Takashi Kobayashi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shota Kobayashi
- Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kei Sonehara
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazunari Tateishi
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shintaro Kanda
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masayuki Hanaoka
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tomonobu Koizumi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
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Percutaneous CT Fluoroscopy-Guided Core Needle Biopsy of Mediastinal Masses: Technical Outcome and Complications of 155 Procedures during a 10-Year Period. Diagnostics (Basel) 2021; 11:diagnostics11050781. [PMID: 33926046 PMCID: PMC8144979 DOI: 10.3390/diagnostics11050781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate technical outcome, diagnostic yield and safety of computed tomographic fluoroscopy-guided percutaneous core needle biopsies in patients with mediastinal masses. METHODS Overall, 155 CT fluoroscopy-guided mediastinal core needle biopsies, performed from March 2010 to June 2020 were included. Size of lesion, size of needle, access path, number of success, number of biopsies per session, diagnostic yield, patient's position, effective dose, rate of complications, tumor localization, size of tumor and histopathological diagnosis were considered. Post-interventional CT was performed, and patients observed for any complications. Complications were classified per the Society of Interventional Radiology (SIR). RESULTS 148 patients (age, 54.7 ± 18.2) underwent 155 CT-fluoroscopy-guided percutaneous biopsies with tumors in the anterior (114; 73.5%), middle (17; 11%) and posterior (24; 15.5%) mediastinum, of which 152 (98%) were technically successful. For placement of the biopsy needle, in 82 (52.9%) procedures a parasternal trajectory was chosen, in 36 (23.3%) a paravertebral access, in 20 (12.9%) through the lateral intercostal space and in 17 (11%) the thoracic anterior midline, respectively. A total of 136 (89.5%) of the biopsies were considered adequate for a specific histopathologic analysis. Total DLP (dose-length product) was 575.7 ± 488.8 mGy*cm. Mean lesion size was 6.0 ± 3.3 cm. Neoplastic pathology was diagnosed in 115 (75.7%) biopsies and 35 (23%) biopsy samples showed no evidence of malignancy. Minor complications were observed in 18 (11.6%) procedures and major pneumothorax requiring drainage insertion in 3 interventions (1.9%). CONCLUSION CT fluoroscopy-guided percutaneous core needle biopsy of mediastinal masses is an effective and safe procedure for the initial assessment of patients with mediastinal tumors.
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Raveglia F, Moneghini L, Cariati M, Baisi A, Guttadauro A, Cioffi U, Scarci M. Case Report: Multidisciplinary Approach for a Rare Case of Thymic Vascular Malformation. Front Surg 2021; 7:624615. [PMID: 33511152 PMCID: PMC7835703 DOI: 10.3389/fsurg.2020.624615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 12/11/2020] [Indexed: 12/04/2022] Open
Abstract
We report the rare case of a 2.5 cm in size mass diagnostic for residual thymus associated with venous vascular malformation (ISSVA classification, 2008) in a 58 years old man. Diagnosis was obtained only after surgical removal that was complicated by a sudden massive bleeding (about 1,500 cc) requiring emergency conversion to median sternotomy. Difficulty in preoperative diagnosis, rarity of histologic pattern, and surgical challenges make this case very interesting for surgeons, pathologists and radiologist. Our message, dealing with mediastinal masses, is: (a) differential diagnosis between the more frequent solid antero-superior mediastinal tumors and vascular malformation should be always considered (b) preoperative angiography should always be performed in case of uncertain diagnosis (c) coil embolization should always be considered to reduce potentially fatal bleeding (d) histologic differentiation with other thymic neoplasms must be always considered.
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Affiliation(s)
- Federico Raveglia
- Department of Thoracic Surgery, Aziende Socio Sanitarie Territoriali-Monza, Monza, Italy
| | - Laura Moneghini
- Department of Pathology, Aziende Socio Sanitarie Territoriali Santi Paolo e Carlo, Milano, Italy
| | - Maurizio Cariati
- Department of Radiology, Aziende Socio Sanitarie Territoriali Santi Paolo e Carlo, Milano, Italy
| | - Alessandro Baisi
- Department of Thoracic Surgery, Aziende Socio Sanitarie Territoriali Santi Paolo e Carlo, Milano, Italy
| | | | - Ugo Cioffi
- Department of Thoracic Surgery, Aziende Socio Sanitarie Territoriali Santi Paolo e Carlo, Milano, Italy
| | - Marco Scarci
- Department of Thoracic Surgery, Aziende Socio Sanitarie Territoriali-Monza, Monza, Italy
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7
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Choudhuri A, Raphael V, Dey B, Khonglah Y, Mishra J, Marbaniang E. Fine-needle aspiration cytology of mediastinal masses: An institutional experience. J Family Med Prim Care 2020; 9:4205-4209. [PMID: 33110833 PMCID: PMC7586570 DOI: 10.4103/jfmpc.jfmpc_656_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/10/2020] [Accepted: 07/01/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: Mediastinal masses are uncommon in clinical practice. Fine-needle aspiration cytology (FNAC) is an important and useful investigation and is considered next to imaging in the diagnosis of mediastinal lesions. Aim: To analyze the mediastinal masses diagnosed on FNAC. Materials and Methods: We retrospectively retrieved twenty-five cases, which underwent FNAC under ultrasound or computed tomography (CT) guidance for mediastinal masses, over a period of 4 years. Histopathological correlations were done in cases wherever available. Results: Among twenty-five cases, which were diagnosed through FNAC, eighteen were males and seven were females with age ranging from 6 to 85 years. Ultrasonography (USG)-guided FNAC was performed in three patients, while CT-guided FNAC was performed in twenty-two patients. Out of twenty-five cases, seventeen cases were malignant, six were benign, and two cases were inadequate. FNAC was useful in the diagnosis of 83.3% of cases. Biopsy and/or cell block correlations were available in fourteen cases. In the malignant category, mediastinal invasion by either squamous cell carcinoma or adenocarcinoma constituted the highest number with eight (47%) out of seventeen cases. Among the nonneoplastic conditions, nonspecific inflammation was the most common cause with two cases (8%) out of total cases followed by one case each of tuberculosis, schwannoma, thymoma, and cystic lesion. Conclusion: USG or CT-guided FNAC is a safe, minimally invasive, and cost-effective procedure, which can provide a precise diagnosis in the mediastinal masses, and may obviate the need for an invasive surgical approach.
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Affiliation(s)
- Ananya Choudhuri
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Vandana Raphael
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Biswajit Dey
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Yookarin Khonglah
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Jaya Mishra
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Evarisalin Marbaniang
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
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8
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Novo M, Nowakowski GS, Habermann TM, Witzig TE, Micallef IN, Johnston PB, Inwards DJ, Botto B, Ristow KM, Young JR, Vitolo U, Ansell SM. Persistent mediastinal FDG uptake on PET-CT after frontline therapy for Hodgkin lymphoma: biopsy, treat or observe? Leuk Lymphoma 2019; 61:318-327. [DOI: 10.1080/10428194.2019.1663422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Mattia Novo
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
- Division of Hematology, Azienda Ospedaliera Universitaria Città Della Salute e Della Scienza di Torino, Torino, Italy
| | | | | | | | | | | | | | - Barbara Botto
- Division of Hematology, Azienda Ospedaliera Universitaria Città Della Salute e Della Scienza di Torino, Torino, Italy
| | - Kay M. Ristow
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Jason R. Young
- Division of Nuclear Medicine, Mayo Clinic, Rochester, MN, USA
| | - Umberto Vitolo
- Division of Hematology, Azienda Ospedaliera Universitaria Città Della Salute e Della Scienza di Torino, Torino, Italy
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Diagnostic outcome and safety of CT-guided core needle biopsy for mediastinal masses: a systematic review and meta-analysis. Eur Radiol 2019; 30:588-599. [DOI: 10.1007/s00330-019-06377-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 06/13/2019] [Accepted: 07/18/2019] [Indexed: 12/17/2022]
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10
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Dixit R, Shah NS, Goyal M, Patil CB, Panjabi M, Gupta RC, Gupta N, Harish SV. Diagnostic evaluation of mediastinal lesions: Analysis of 144 cases. Lung India 2017; 34:341-348. [PMID: 28671165 PMCID: PMC5504891 DOI: 10.4103/lungindia.lungindia_311_16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Mediastinum is a “Pandora's box” with many neoplastic and nonneoplastic lesions. The purpose of this study was to analyze our institutional experience of mediastinal lesions on fine-needle aspiration cytology (FNAC) and/or biopsy. Materials and Methods: This study was an analysis of 144 patients who had undergone ultrasound-guided FNAC and/or core biopsy for mediastinal lesions. Results: A total of 144 cases of suspected mediastinal masses were seen, and in 139 cases, tissue diagnosis was attempted. Out of 139 cases, 93 cases were neoplastic in nature (67%), 32 were nonneoplastic (23%), and 14 remained inconclusive (10%). Among neoplastic mediastinal lesions, metastatic carcinoma (37.4%) was the most common neoplastic lesion, followed by non-Hodgkin's lymphoma (12.2%), Hodgkin's lymphoma (7.1%), thymic lesions (3.5%), etc. Among nonneoplastic conditions, tuberculosis was the most common lesion (20.1%). An accurate tissue diagnosis was made in 89.9% cases by FNAC or core biopsy of mediastinal lesions in this study. Procedure-related mortality was nil. Complications were mostly minor and included chest pain in 24.5%, small pneumothorax in 13.6% requiring closed tube thoracostomy in 1.4%, and scanty hemoptysis in 9.3% cases. Conclusion: Neoplastic mediastinal lesions are more common than nonneoplastic lesions, with metastatic carcinoma being the most common cause followed by tuberculosis. A wide variety of lesions observed in this study stress on the importance of cytohistological diagnosis in all cases of mediastinal lesions for the final diagnosis and management planning. A guided FNAC or core biopsy is still accurate, well tolerated, and devoid of major complications.
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Affiliation(s)
- Ramakant Dixit
- Department of Respiratory Medicine, J.L.N. Medical College, Ajmer, Rajasthan, India
| | - Narender Singh Shah
- Department of Radiation Oncology, J.L.N. Medical College, Ajmer, Rajasthan, India
| | - Mukesh Goyal
- Department of Respiratory Medicine, J.L.N. Medical College, Ajmer, Rajasthan, India
| | - Chetan B Patil
- Department of Respiratory Medicine, J.L.N. Medical College, Ajmer, Rajasthan, India
| | - Mukesh Panjabi
- Department of Pathology, J.L.N. Medical College, Ajmer, Rajasthan, India
| | - Rakesh C Gupta
- Department of Respiratory Medicine, J.L.N. Medical College, Ajmer, Rajasthan, India
| | - Neeraj Gupta
- Department of Respiratory Medicine, J.L.N. Medical College, Ajmer, Rajasthan, India
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