Author of

• 10974

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  P1.21 - Poster Session 1 - Diagnosis and Staging (ID 169)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10980

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    P1.21-006 - Diagnostic value of CT fluoroscopy-guided transbronchial biopsy in endobronchially invisible and transthorasically inaccessible nodule/mass of the lung (ID 2408)

    09:30 - 09:30  |  Author(s): F. Sever
    • Abstract

    Background
    To evaluate the usefulness of transbronchial needle biopsy (TBNB) under computed tomography fluoroscopy (CTF) for pulmonary nodule/mass that is invisible at bronchoscopy and not suitable for biopsy using transthoracic approach.

    Methods
    The study included 23 patients (14 men, 9 women and mean age of 57 years) with pulmonary mass/nodule on computed tomography (CT) scans. In all patients, there was no an endoluminal lesion at bronchoscopy previously carried out and transthoracic biopsy was considered to be inappropriate owing to location of the lesion and/or presence of serious emphysema with abnormal pulmonary function test result. The procedure was done in a CT room with a monitor faced to the radiologist, while performing the broncoscopy by a bronchoscopist. CT fluoroscopic real-time scans were used to confirme that the tip of the bronchoscopic needle was exactly inside of the pulmonary target lesion. After the biopsy performed under CTF guidance, the obtaining samples were examined histopathologically.

    Results
    Figure 1 CTF-guided transbronchial biopsy samples were adequate for definitive diagnosis in 19 (83%) patients and inadequate in 4 (17%) patients. Inadequate results were caused by inability to reach the lesion as seen on CTF scans. 15 nodules/masses were diagnosed as malignant, 4 as benign. For malignant lesions, the final diagnoses were adenocarcinoma (n=5), small cell lung cancer (NSCLC) (n=4), non-NSCLC of undetermined cell type(n=2), epidermoid carcinoma (n=2), lymphoma (n=1) and sarcoma (n=1). Among the benign lesions, specific diagnoses were obtained in 2 (%50) patients. Mild to moderate hemoptysis occurred in 4 (17%) patients.

    Conclusion
    CT fluoroscopy-guided transbronchial biopsy is an effective and safe method to obtain the diagnosis of the lung lesion. It seems to be particularly valuable with a real-time guidance in pulmonary nodule/mass which is invisible at bronchoscopy and inappropriate for transthoracic biopsy.