Percutaneous automated gun biopsy of localized pulmonary lesions

Percutaneous needle aspiration biopsy under the imaging guidance in the diagnosis of intrathoracic diseases has become a standard practice. Core tissue obtained by automated gun biopsy (AGB) is believed to be more diagnostic than materials from fine needle aspiration (FNA) by many cytopathologists. The authors evaluated the role of automated gun biopsy in localized pulmonary lesions with respect to the its accuracy and complication. We performed 107 percutaneous biopsies in localized pulmonary lesions under fluoroscopic guidance among 107 patients: AGB using 18G or 20G was done in 81 patients, and both AGB and FNA was done in 26 patients. Biopsy samples sufficient for histologic diagnosis were obtained in 94 (87.9%) of 107 patients, AGB in 73 (90.1%) of 81 patients and AGB and FNA in 21 (80.8%) of 26 patients. 11 of 13 negative results were due to inadeguate specimen size for the histologic diagnosis or were composed of necrotic areas, and 2 of 13 negative results were obtained through nontarget tissue. 10 patients developed pneumothorax and 4 of them required chest tube insertion. Minimal hemoptysis was found in 3 patients. Percutaneous automated gun biopsy under fluoroscopic guidance was easy and simple method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions