Percutaneous Biopsy of a Posterior Mediastinal Mass Through an Extrapleural Window Created With Dilute Contrast

Bhagat, Vishal J.; Wilson, Mark W.; Sudilovsky, Daniel; LaBerge, Jeanne M.; Gordon, Roy L.; Kerlan, Robert K.

doi:10.1097/00005382-199904000-00005

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“…Percutaneous drainage techniques in the pleural space using CT or ultrasound guidance are well established (1). In cases of CT-guided biopsy of mediastinal masses or lymph nodes, recent papers have described widening of the extrapleural soft tissues with air, saline and lidocaine mixtures, or even with radiographic contrast media to create a safe window for access to the lesion (2)(3)(4)(5). Artificial pneumothorax, created using a blunt needle to access the pleural space without damaging the lung has also been reported (6), but in our experience is more difficult to achieve consistently.…”

Section: Discussionmentioning

confidence: 99%

An Infected Mediastinal Cyst

Lawson

Mason

2000

Canadian Respiratory Journal

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The authors describe a 43-year-old patient who had a mediastinal mass that became infected after a transbronchial needle aspirate biopsy. A paraspinal, extrapleural window with a saline-lidocaine mixture was created that allowed the placement of a percutaneous drainage catheter into the infected lesion. This procedure resulted in an excellent clinical outcome, and obviated the need for a thoracotomy and more invasive surgical management.

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