The Importance of Computed Tomography Guided Transthorasic Aspiration Biopsy/Cell Block Method in Early Diagnosis and Treatment of Lung Lesions: Cytopathologic Analysis in 354 Cases

Objective: The aim of this study was to evaluated the effectiveness of computed tomography(CT) guided transthorasic fine needle aspiration biopsy in the diagnosis of lung mass lesions. Material and Method: In this study, we are presenting 354 CT guided TTFNAB materials. The 348 of aspirations were performed from lung directly and 6 of them were performed from masses with mediastinal location. After the lesion was localized by CT, aspiration biopsy was performed by thoracic surgeon with 20-22 gauge Chiba needle by using 20 ml.Results: Among the 220 patients who underwent TTFNAB (354 aspiration biopsy), 163(46.04%) were diagnosed as tumor, 74(20.90%) as suspicious lesion, 71(20.05) as benign lesion and 46(12.99%) as aspirate nondiagnostic. 140(39.54%) aspirata cell blocks were applied to 134 cases. Immunohistochemical and histochemical studies were performed in these cases and type differentiation could be made in tumor.Conclusion: TTFNAB-CB in expert hands and experienced pathologists is fairly accurate for lung masses and can be regarded as an acceptable procedure for early diagnose and treatment planning purposes in most lung lesions.

Anahtar Kelimeler:

lung; computed tomography

PDF

___

Referans1-Ferlay J, Shin HR, Bray F, Forman D,Mathers C, Parkin DM. et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-2917.Referans2-Pak HK, Yokota S, Teplitz RL, Shaw SL, Werner JL Rapid staining techniques employed in fine needle biopsy of the lung. Acta Cytol 1981;25:178-84. Referans3-Miller DA, Carrasco CH, Katz RL, Cramer FM,Wallace S,Charnsangavej C. Fine needle aspiration biopsy:the role of immediate cytologic assesment. AJR 1985;144:793-794. Referans4-Austin JHM, Cohen MB. Value of having cytopathologist present during percutaneous fine needle aspiration biopsy of lung:report of 55 cancer patients and meta-analysis of the literature. AJR 1993;160:175-177. Referans5-Silverman FJ, Finley JL, O’Brien KF, Dabbs DJ, Park HK, Larkin EW et al. Diagnostic accuracy and role of immadiate interpretation of fine needle aspiration biopsy specimens from various sites. Acta Cytol 1989;33:791-796. Referans6-Conces DJ, Schwenk GR Jr, Doering PR, Giant MD.. Thorasic needle biopsy. Improved results utilizing a team approach. Chest 1987;91:813-816. Referans7-Madan M, Bannur H. Evaluation of fine needle aspiration cytology in the diagnosisof lund lesions. Turk jpath 2010;26:1-6. Referans8-Charing MJ, Stutley JE, Padley SP, Hansell DMl. The value of negative needle biopsy in suspected operable lung cancer. Clin Radiol 1991;44:147-149. Referans9-Mack MJ, Hazelrigg SR, Landrenau RJ, Acuff TE. Thoracoscopy for the diagnosis of the indeterminate solitary pulmonary nodule. Ann Thorac Surg 1993;56:825-832. Referans10-Zarbo RJ, Fenoglio-Preiser CM. Interinstitutional database for comparion of performance in in lung fine-needle aspiration cytology. Arch Pathol Lab Med 1992;116:463-470. Referans11-Trail ZC, Gleason FV. Delayed pneumothorax after CT guided percutaneous fine needle aspiration lung biopsy. Thoax 1997;52:575-576. Referans12- Gangopadhyay M, Chackrabarti I, Ghosh N, Giri A. Computed tomography guided fine needle aspiration cytology of mass lesions of lung: our experience. Indian J Med Paediatric Oncol 2011;32:192-196. Referans13-Boskovic T, Stanic J, Pena-Karan S, Zarıgolidis K. Pneumothorax after transthorasic needle biopsy of lung lesions under CT guidance. J Thorac Dis 2014;6:99-107. Referans14-Davidson MR, Gazdar AF, Clarke BE. The pivotal role of pathology in management of lung cancer. J Thorac Dis 2013;5:463-478. Referans15-Kocijancic I, Kocijancic K. CT-guided percutaneous transthorasic needle biopsy of lung lesions-2-year experience at the Institute of Radiology in Ljubljana. Radiol Oncol 2007;41:99-106. Referans16-Westcott JL. Direct percutaneous needle aspiration of localized lesions:results in 422 patients. Radiology1980;137:31-35. Referans17-Kazerooni EA, Lim FT, Mikhail A, Martinez FJ. Risk of pneumothorax in CT-guided transthorasic aspiration needle biopsy of the lung. Radiology 1996;198:371-375. Referans18-Li H, Boiselle PM, Shepared JO, Trotman-Dickenson B,McLoud TC. Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung comprasion of small and large pulmonary nodules. AJR Am J Roentgenol 1996;167:105-109. Referans19-Khouri NF, Stitik FP, Erozan YS. Transthorasic needle aspiration biopsy of benign and malignant lung lesions. AJR Am J Roentgenol 1985;144:281-288. Referans20-Stanley JH, Fish GD, Andriole JG. Lung lesions cytologic diagnosis by-fine needle biopsy. Radiology 1987;162:389-391. Referans21-Klein JS, Zarka MA. Transthorasic needle biopsy:an overwiew. J Thorasic Imaging 1997;12:232-249. Referans22-Gupta S, Krishnamurty S, Bromeling LD, Morello FA Jr, Wallace MJ, Ahrar K et al. Small subpleural pulmonary lesions:short-versus long- needle- path CT-guided Biopsy-- comprasion of diagnostic yields and complications. Radiology 2005;234:631-637.Referans23-Kline TS. Handbook of Fine Needle Aspiration Biopsy Cytology, 2nd ed. New York:Churchill Livingstone. 1988;492pp. Referans24-Kowalewski J, Sir J, Dancewicz M, Swiniarska J, Peplinski J. Fine needle aspiration biopsy under CT-guidance-usefulness in diagnosis of malignant lung tumors. Pneumonol Allergol Pol 2004;72:177-180.Referans25-Wu X, Groves FD, McLaughin CC, J emal A, Martin J, Chen VW. Cancer incidence patterns among adholescents and young adults in the United States. Cancer Causes Control 2005;16:309-320. Referans26-Mathew EP, Nair V. Role of cell block in cytopathologic evaluation of image–guided fine needle aspiration cytology. J Cytol 2017;34:133-138.Referans27-Zemansky AP Jr. Examination of tumour cells; Analysis of 113 cases checked against subsequent examination of tissue. Am J M. Sc 1928;175:489-504.