Utility of computed tomography (CT) and of fine needle aspiration biopsy (FNAB) in early diagnosis of fungal pulmonary infections. Study of infections from filamentous fungi in haematologically immunodeficient patients

Carrafiello, Gianpaolo; Laganà, Domenico; Nosari, Am; Guffanti, Cleofe; Morra, Enrica; Recaldini, Chiara; D'alba, Mj; Sonvico, U; Vanzulli, Angelo; Fugazzola, Carlo

doi:10.1007/s11547-006-0004-9

Cited by 40 publications

(44 citation statements)

References 12 publications

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“…Magnetic resonance imaging (MRI) currently has a limited use because of expense, difficulty accessing the patient within the magnet, the relatively poor visualisation of lung lesions, and difficulties with ferromagnetic instruments within the magnetic field. In general, CT-guided percutaneous lung biopsy has been performed with a diagnostic yield of 80-100% [8][9][10]. Similar excellent data were obtained for the diagnosis of invasive aspergillosis (IA).…”

Section: Percutaneous Transthoracic Lung Biopsiesmentioning

confidence: 77%

“…In different studies, infection was documented in 70% [11], in 78% [12], in 80% [4], and in 100% [13]. Overall, the procedure is safe and reliable in obtaining diagnostic materials [9]. This intervention requires platelet counts of >60,000/ml [11] which is frequently not possible in profoundly neutropenic patients.…”

Section: Percutaneous Transthoracic Lung Biopsiesmentioning

confidence: 99%

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Diagnosing Aspergillosis: The Role of Invasive Diagnostic Interventions

Lass‐Flörl

Freund

2009

Aspergillosis: From Diagnosis to Prevention

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The diagnosis of invasive aspergillosis remains challenging and current conventional methods are limited for the diagnosis of invasive fungal infections. The gold-standard for the definite diagnosis of proven invasive pulmonary aspergillosis remains either histopathologic, cytopathologic or direct tissue examination, based on the documentation of typical hyphae and a positive culture of Aspergillus spp. This chapter reviews the yield of invasive procedures in the diagnosis of aspergillosis. Biopsies may be taken percutaneously, bronchoscopically, via open surgery or video-assisted thorascopic surgery. Computed tomography-guided percutaneous, bronchoscopic and open lung biopsies have been performed with a diagnostic yield of 80-100, 51 and 70%, respectively. Bronchoscopy with bronchoalveolar lavage is generally helpful in diagnosing invasive pulmonary aspergillosis, especially in immunocompromised patients with diffuse lung involvement. The sensitivity and specificity of a positive result of bronchoalveolar lavage fluid are ∼50 and 97%, respectively. All specimens obtained via invasive interventions including bronchoalveolar lavage should be processed for microscopy and cytology, fungal cultures and by means of any other available procedure (e.g., Aspergillus PCR and galactomannan). Combining microscopy and culture will increase the diagnostic yield by 15-20%. Combining culture, microscopy, serology, and Aspergillus PCR in lung tissues and/or bronchial samples will increase the diagnostic yield by 99%.

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Section: Percutaneous Transthoracic Lung Biopsiesmentioning

confidence: 77%

Section: Percutaneous Transthoracic Lung Biopsiesmentioning

confidence: 99%

Diagnosing Aspergillosis: The Role of Invasive Diagnostic Interventions

Lass‐Flörl

Freund

2009

Aspergillosis: From Diagnosis to Prevention

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“…The procedure is relatively safe [16,21,22] and therefore useful in the evaluation of pulmonary lesions, because of its high diagnostic yield, especially for IPA [21]. The sensitivity is indicated with 70.6% [23], 80% [22] and 100% [24], respectively.…”

Section: Percutaneous Transthoracic Lung Biopsy: Ct Guided Biopsiesmentioning

confidence: 99%

“…The sensitivity is indicated with 70.6% [23], 80% [22] and 100% [24], respectively. A low diagnostic yield for fungal infections was reported by Ho et al [16] with 29.4% for FNAB.…”

Section: Percutaneous Transthoracic Lung Biopsy: Ct Guided Biopsiesmentioning

confidence: 99%

Biopsy Procedures for Molecular Tissue Diagnosis of Invasive Fungal Infections

Mrazek

Lass‐Flörl

2011

Curr Infect Dis Rep

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The incidence of invasive fungal infections (IFI) has increased substantially and the epidemiology has changed dramatically in recent years. Candida albicans is still most important, but non-albicans species, Aspergillus species, Glomeromycota (formerly Zygomycetes) and Fusarium species are an increasing cause of IFIs. Due to this growing diversity, the identification of the causative organism to genus and species level is important to perform best and adequate treatment. The early, sensitive and specific detection of IFIs remains challenging and current conventional methods are limited. The golden standard for the definite diagnosis of proven pulmonary infection remains either histopathologic, cytopathologic or direct tissue examination. Invasive procedures are necessary to obtain reliable specimens and biopsies may be taken percutaneously, bronchoscopically, via open surgery or via video-assisted thorascopic surgery. Molecular methods, like PCR or in situ hybridization, are a promising diagnostic tool for rapid and reliable species identification and should be performed in addition to microscopic examination and culture to increase the sensitivity for the diagnosis of IFI. Combining culture, microscopy, serology, and PCR in lung tissues and/or bronchial samples will increase the diagnostic yield by 99%. Here, we give an overview of biopsy procedures for molecular tissue diagnosis of IFI.

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“…Percutaneous biopsy yields tissue samples for diagnosis and staging and facilitates differentiation of primary cancer from distant metastasis or infective and inflammatory lesions, which is crucial for correct management of lung lesions (1). Percutaneous biopsy has also been used to obtain tissue for genetic and immunologic testing of cancer mutations, thus improving the care of patients undergoing targeted chemotherapy (2,3).…”

Section: Introductionmentioning

confidence: 99%

Intrathoracic tumors in contact with the chest wall – ultrasonographic and computed tomography guided biopsy comparative evaluation

Abish¹,

Mohammed²

2014

IOSRJDMS

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Results: No significant difference was found for patient age (P = .741), sex (P = .900), lesion size (P = .206), or lesion origin (P = .788). Median time was 576 seconds for CT-guided biopsy (25th percentile, 418 seconds; 75th percentile, 714 seconds) and 311 seconds for US-guided biopsy (25th percentile, 152 seconds; 75th percentile, 480 seconds) (P < .001). Post-procedural pneumothorax was observed in 24 of 162 (14.8%) CTguided procedures and in five of 98 (5.1%) US-guided procedures (P = .025); hemorrhage occurred in two of

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Utility of computed tomography (CT) and of fine needle aspiration biopsy (FNAB) in early diagnosis of fungal pulmonary infections. Study of infections from filamentous fungi in haematologically immunodeficient patients

Abstract: Percutaneous CT-guided lung biopsy is an easy, safe and reliable procedure to obtain diagnostic material. Histological discrimination between Aspergillus and Mucor is important in order to plan the correct therapeutic protocols, as Mucor is usually resistant to azoles.

Cited by 40 publications

References 12 publications

Diagnosing Aspergillosis: The Role of Invasive Diagnostic Interventions

Diagnosing Aspergillosis: The Role of Invasive Diagnostic Interventions

Biopsy Procedures for Molecular Tissue Diagnosis of Invasive Fungal Infections

Intrathoracic tumors in contact with the chest wall – ultrasonographic and computed tomography guided biopsy comparative evaluation

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