Use of percutaneous needle biopsy in the investigation of solitary pulmonary nodules.

Percutaneous Core Needle Biopsy vs. Fine Needle Aspiration in Diagnosing Benign Lung Lesions

“…FNA is generally considered to be the procedure of choice for the initial evaluation of peripheral pulmonary lesions. 18 Reports of large series 8,10,13,15,16,18 indicate that malignant diseases can be readily distinguished from nonmalignant diseases by cytologic examination of the aspirate. A definitive diagnosis of malignancy is yielded in 50-95% of malignant pulmonary lesions, depending upon their size and location.…”

“…9,10,13,18 The reason for the low yield of FNA in the diagnosis of benign lesions lies in the different capabilities of cytologic and histologic techniques in analyzing the nature of pathologic findings. Percutaneous core needle biopsy (PCNB) that provides adequate tissue material for histologic analysis may contribute significantly to the diagnosis of nonneoplastic lesions, with low morbidity.…”

“…A definitive diagnosis of malignancy is yielded in 50-95% of malignant pulmonary lesions, depending upon their size and location. 4,[8][9][10]13,15,18 However, a definitive benign diagnosis is generally obtained in < 50% and may be as low as 12%. 3,6 There are two main limitations associated with the FNA technique: (1) the cytologic aspirate obtained provides a relatively small sample, sometimes from a noninvolved area (sample error), and (2) cytologic interpretive error may occur with disease processes that are better defined by an overall morphologic pattern rather than by individual cytologic features, so a specific diagnosis is infrequently obtained from aspirated cytologic material in benign lesions (Figures 1 and 2).…”

Diagnostic Yield of Transthoracic Needle Aspiration Biopsy following Negative Fiberoptic Bronchoscopy in 103 Patients with Peripheral Circumscribed Pulmonary Lesions

“…All the TNB diagnoses were those of malignancy, and the overall diagnostic yield in malignant lesions was 73.8%. According to the experi ences from other series, TNB was unsuitable in the diag nosis of benign lesions [2][3][4][5], Unspecific inflammation in TNB should not be considered evidence of benignity, and a definitive benign diagnosis is therefore seldom made by TNB. Apparently, needle biopsy of benign lesions must provide tissue specimens for histology rather than cytolo gy in order to increase the diagnostic yield.…”

“…The cost of FOB is three to four times that of TNB, and both are low-cost diagnostic procedures carrying a low incidence of complications [1,[2][3][4][5] com pared to the high-cost explorative thoracotomy [6].…”