Transthoracic Fine Needle Aspiration Biopsy of Subcarinal Lesion: Oblique Approach Using Biplane Fluoroscopic Guidance.
10.3348/jkrs.1995.33.3.379
- Author:
Yo Won CHOI
;
Sung Tae KIM
;
Heung Suk SEO
;
Seok Chol JEON
;
Chang Kok HAHM
- Publication Type:Original Article
- MeSH:
Adenocarcinoma;
Biopsy*;
Biopsy, Fine-Needle*;
Bronchi;
Carcinoma, Adenosquamous;
Carcinoma, Small Cell;
Carcinoma, Squamous Cell;
Chest Tubes;
Diagnosis;
Drainage;
Hemoptysis;
Humans;
Lymph Nodes;
Needles;
Neoplasm Metastasis;
Pneumothorax;
Spine;
Thorax;
Tomography, X-Ray Computed;
X-Ray Film
- From:Journal of the Korean Radiological Society
1995;33(3):379-382
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate effectiveness of oblique approach under biplane fluoroscopic guidance in transthoracic fine needle aspiration biopsy. MATERIALS AND METHODS: Fourteen consecutive patients underwent transthoracic fine needle aspiration biopsy for subcarinal lesions. Subcarina was the only accessible biopsy site in 13 patients. Subcarinal biopsy was performed to determine the presence of metastasis in an enlarged subcarinal lymph node in the remaining one patient. Before biopsy, we evaluated the size and location of the lesion on preliminary plain chest X-ray film and CT scan. Under dual projection fluoroscopic guidence, biopsy was performed through right posterior intercostal space with the patient prone by using oblique approach. On 15 degree LAO projection the needle was directed to the area anterior to the spine and advanced to the line extending through the posterior wall of the main bronchus. RESULTS: Cytologic diagnosis was made in 12 out of 14 patients(accuracy 85.7%). The final diagnosis consisted of 5 squamous cell carcinoma, 5 small cell carcinoma, 1 adenocarcinoma and 1 adenosquamous carcinoma. Pneumothorax developed in 2 patients(14%) and was managed by chest tube drainage. Mild hemoptysis was observed in 2. CONCLUSION: Transthoracic fine needle aspiration biopsy using oblique approach under biplane fluoroscopic guidance is a relatively safe and sensitive method for the histologic diagnosis of subcarinal lesion.
