Utility of percutaneous ultrasound guided biopsy in the diagnosis of anterior mediastinal mass lesions

Abstract

Introduction: mediastinal masses include a broad spectrum of histopathological and radiological entities. Although imaging modalities aid at narrowing the purposed differential diagnosis, accurate categorization is not always possible. Objective: to assess the efficacy as well as safety of percutaneous ultrasound guided biopsy modality in the proper diagnosis of anterior mediastinal lesions.Materials and methods: Forty patients presented with anterior mediastinal masses were enrolled in this study. Each patient was subjected to CT chest with contrast, US guided biopsy from the anterior mediastinal lesions and obtained specimens underwent histopathological examination. Then, patients were observed for possible post-procedural complications. Results: 97.5% of the included cases were symptomatic; with dyspnea [representing 62.5%] was the most frequent complaint among our cases, followed by cough and fever representing 50% and 37%, respectively. The most frequent lesions were lymphoma (40%) followed by metastatic carcinoma (25%) and thymoma (15%). Two cases showed inconclusive results (failure rate 5%).Conclusions: Combined clinico-radiological data can narrow the differential diagnosis of anterior mediastinal masses; yet histopathological examination remains the mainstay of the precise diagnosis. Percutaneous US guided biopsy is claimed to be a useful, minimally invasive cost-effective tool for proper sampling, with minimal complications and low failure rate.