Fine needle aspiration biopsy under CT control of small (<20 mm) focal pulmonary lesions-opportunities and challenges

Full text: Introduction: CT assisted percutaneous needle aspiration (FNA) of lung lesions is a safe and reproducible procedure, recently more often used for diagnostics. The aim of this study is to present our experience regarding the capabilities and accuracy of FNA under CT control for determining the nature of small (<2,0 cm in diameter) pulmonary lesions. Materials and Methods: Fifty- nine patients (35 men and 24 women), aged 21-89, with pulmonary foci with dimensions 2.0 cm or less , have undergone FNA under CT control. Fifty-one of these have had proven primary malignancy. Maximum diameter of focal lesions is 1,0-1,5 cm in 18 patients and 1.5-2.0 cm in 41 patients. Disposable needles 19-20 -21G have been used. Cytological evaluation of FNA samples was performed in all patients. The sensitivity and accuracy of diagnistics have been calculated. The number and type of any complications have been evaluated. Results: In 54 (91.52%) of 59 patients the samples were taken using FNA under CT control, which had been sufficient for diagnosis. Malignant diseases had been proven or suspected in 45 patients, and benign or atypical in 9 cases. In 9 patients with no evidence of malignancy a follow-up was conducted, including CT scanning of the lung. Overall sensitivity was 89 %, the specificity was 100%, and diagnostic accuracy - 93%. Of all patients 12 (22.22%) experienced complications - hemoptysis and partial pneumothorax, a percutaneous drainage is placed in 5 cases. Conclusion: In case of small lung lesion with negative results from bronchial or transbronchial biopsy, FNA performed under CT control allows to obtain cytological or histological results, leading to a high diagnostic accuracy close to the one obtainedforlarger lesions