PURPOSE: To assess the safety and usefulness of ultrasonography-guided transthoracic cutting biopsy for lung lesions. MATERIALS AND METHODS: Eighty-eight patients (66 men, 22 women, mean age 59 years) with lung lesions underwent an ultrasonography(USG)-guided transthoracic cutting biopsy. The final diagnosis was based on the findings of surgery and clinical and radiological follow-ups. The histopathologic results and diagnostic accuracy of cutting biopsy were determined. Also, the complication rate was statistically evaluated according to the mass size, number of biopsies, and the presence or absence of pleural effusion. RESULTS: Biopsy specimens were successfully obtained in all patients. 79 of 88 lesions (89.8%) were established by histopathology. The final diagnosis was malignant in 58 and benign in 28. The remaining 2 patients were lost to follow-up. Diagnostic sensitivity for malignant lesions was 89.6% (52/58) and that for benign lesions was 96.4% (27/28). Procedure-related complications occurred in 9 patients (10.2%) including pneumothorax (n = 2) and hemoptysis (n = 7). And there was no significant difference according to mass size, number of biopsies, or presence of pleural effusion. CONCLUSION: USG-guided transthoracic cutting biopsy is a useful and safe method for technically-feasible lung lesions.
Biopsy ; Female ; Follow-Up Studies ; Hemoptysis ; Humans ; Lost to Follow-Up ; Lung ; Male ; Pneumothorax ; Radiography, Interventional

INTRODUCTIONTreatment of acute lymphoblastic leukaemia (ALL) using intensive chemotherapy has resulted in high cure rates but also substantial morbidity. Infective complications represent a significant proportion of treatment-related toxicity. The objective of this study was to describe the microbiological aetiology and clinical outcome of episodes of chemotherapy-induced febrile neutropaenia in a cohort of children treated for ALL at our institution.

MATERIALS AND METHODSPatients with ALL were treated with either the HKSGALL93 or the Malaysia-Singapore (Ma-Spore) 2003 chemotherapy protocols. The records of 197 patients who completed the intensive phase of treatment, defined as the period of treatment from induction, central nervous system (CNS)-directed therapy to reinduction from June 2000 to January 2010 were retrospectively reviewed.

RESULTSThere were a total of 587 episodes of febrile neutropaenia in 197 patients, translating to an overall rate of 2.98 episodes per patient. A causative pathogen was isolated in 22.7% of episodes. An equal proportion of Gram-positive bacteria (36.4%) and Gram-negative bacteria (36.4%) were most frequently isolated followed by viral pathogens (17.4%), fungal pathogens (8.4%) and other bacteria (1.2%). Fungal organisms accounted for a higher proportion of clinically severe episodes of febrile neutropaenia requiring admission to the high-dependency or intensive care unit (23.1%). The overall mortality rate from all episodes was 1.5%.

CONCLUSIONFebrile neutropaenia continues to be of concern in ALL patients undergoing intensive chemotherapy. The majority of episodes will not have an identifiable causative organism. Gram-positive bacteria and Gram-negative bacteria were the most common causative pathogens identified. With appropriate antimicrobial therapy and supportive management, the overall risk of mortality from febrile neutropaenia is extremely low.

Candidiasis ; epidemiology ; Chemotherapy-Induced Febrile Neutropenia ; epidemiology ; microbiology ; Child ; Cohort Studies ; Escherichia coli Infections ; epidemiology ; Gram-Negative Bacterial Infections ; epidemiology ; Gram-Positive Bacterial Infections ; epidemiology ; Humans ; Influenza, Human ; epidemiology ; Klebsiella Infections ; epidemiology ; Mycoses ; epidemiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Pseudomonas Infections ; epidemiology ; Retrospective Studies ; Singapore ; epidemiology ; Staphylococcal Infections ; epidemiology ; Virus Diseases ; epidemiology