The diagnostic yield and safety of ultrasound-assisted transthoracic fine-needle aspiration of drowned lung
Date
2011
Authors
Koegelenberg C.F.N.
Bolliger C.T.
Irusen E.M.
Wright C.A.
Louw M.
Schubert P.T.
Diacon A.H.
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Abstract
Background: Proximal lung tumors, though not discernable by means of transthoracic ultrasound (US), may cause varying degrees of pulmonary collapse and postobstructive pneumonitis which may give rise to a 'drowned lung' appearance on chest computed tomography (CT) and US. The diagnostic yield for malignancy of US-assisted transthoracic fine-needle aspiration (FNA) of these areas of drowned lung is unknown. Objectives: We aimed to explore the feasibility of US-assisted FNA in this setting by prospectively investigating its diagnostic yield and safety. Methods: We enrolled 31 patients (aged 59.4 ± 9.7 years, 17 males) with central tumors and secondary drowned lung on CT scan. A respiratory physician performed transthoracic US to identify the target drowned lung tissue. Three US-assisted superficial FNA passes (≤20 mm from the pleura) were followed by 3 deeper FNA passes (>20 mm) aimed in the direction of a visible or approximated central mass. Rapid on-site evaluation of specimens was used. Results: Superficial FNA was diagnostic in 11 patients (35.5%), whereas deeper FNA was diagnostic in 23 patients (74.2%, p = 0.002). Deeper FNA confirmed malignancy in all cases with diagnostic superficial FNA. We observed no pneumothoraces or major hemorrhage. All patients were ultimately diagnosed with malignancy (bronchogenic carcinoma, n = 30; lymphoma, n = 1). Conclusions: US-assisted FNA of drowned lung has an acceptable diagnostic yield and is safe. Copyright © 2010 S. Karger AG, Basel.
Description
Keywords
adult, article, cancer diagnosis, clinical trial, computer assisted tomography, diagnostic test accuracy study, diagnostic value, drowned lung, echography, feasibility study, female, human, human tissue, large cell carcinoma, lung adenocarcinoma, lung carcinoma, lung disease, lung hemorrhage, lung small cell cancer, lung squamous cell carcinoma, major clinical study, male, nodular sclerosis Hodgkin lymphoma, patient safety, pleura, priority journal, prospective study, pulmonology, sensitivity and specificity, transthoracic aspiration, undifferentiated carcinoma
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