scholarly journals Yield of ultrasound guided transthoracic needle aspiration in peripheral intrathoracic mass lesions

2021 ◽  
Vol 6 (2) ◽  
pp. 105-110
Author(s):  
Sajitha M ◽  
P Sukumaran ◽  
K P Venugopal ◽  
Jayakumar T K
Keyword(s):  
Complication Rate ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Safe Procedure ◽  
Ultrasound Guided ◽  
Ct Guided ◽  
High Diagnostic Yield ◽  
Therapeutic Decisions ◽  
Intrathoracic Mass ◽  
Mass Lesions

In thoracic lesions, early diagnosis and sorting out into malignant- benign is important regarding the therapeutic decisions and prognosis. Ultrasound guided Transthoracic needle aspiration (TTNA) and Corebiopsy (CNB) are described to be safe accurate high yielding means of diagnosis. The study aims to determine the yield and safety of TTNA in peripheral intrathoracic mass lesions. Study was conducted in government teaching institution in Kerala. Patients with intrathoracic peripheral mass lesions which were visualized by USG were subjected to TTNA, and sent for cytopathology. The patients with inconclusive results were subjected to either USG guided or CT guided CNB. The patients were followed up till a conclusive diagnosis obtained. The results were classified as conclusive /definitive or inconclusive. Diagnostic yield and complication rate calculated.USG guided TTNA had an overall diagnostic yield of 65.5%,with 72.15% yield in malignancy. It had high diagnostic yield in lung carcinoma(82.3%) and was a safe procedure with complication rate of 3% only.Combined with USG guided CNB, the overall yield became 86.66% with a cumulative yield of 91.13% in malignancy with no increase in complication rate. Ultrasound guided TTNA is a safe procedure with good yield in peripheral lung malignancies.Ultrasound guided transthoracic needle aspiration and core cut together has a high diagnostic yield in peripheral intrathoracic masses and is accurate in differentiating malignant and benign lesion with a good safety profile.

scholarly journals Initial Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Lesions Performed by a Pulmonologist

2019 ◽  
Vol 8 (6) ◽  
pp. 821 ◽  
Author(s):  
June Hong Ahn ◽  
Jong Geol Jang
Keyword(s):  
Diagnostic Accuracy ◽  
Complication Rate ◽  
Predictive Value ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Safe Procedure ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions ◽  
Percutaneous Transthoracic Needle Biopsy

In the diagnosis of lung lesions, computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) has a high diagnostic yield and a low complication rate. The procedure is usually performed by interventional radiologists, but the diagnostic yield and safety of CT-guided PTNB when performed by pulmonologists have not been evaluated. A retrospective study of 239 patients who underwent CT-guided PTNB at Yeungnam University Hospital between March 2017 and April 2018 was conducted. A pulmonologist performed the procedure using a co-axial technique with a 20-gauge needle. Then diagnostic yield and safety were assessed. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of malignancy were 96.1% (171/178), 100% (46/46), 100% (171/171), and 86.8% (46/53), respectively. The diagnostic accuracy was 96.9% (217/224) and the overall complication rate was 33.1% (82/248). Pneumothorax, hemoptysis, and hemothorax occurred in 27.0% (67/248), 5.2% (13/248), and 0.8% (2/248) of the patients, respectively. Univariate analyses revealed that pneumothorax requiring chest tube insertion was a significant risk factor (odds ratio, 25.0; p < 0.001) for diagnostic failure. CT-guided PTNB is a safe procedure with a high diagnostic accuracy, even when performed by an inexperienced pulmonologist. The results were similar to those achieved by interventional radiologists as reported in previously published studies.

Transoesophageal endobronchial ultrasound-guided needle aspiration (EUS-B-NA) for poorly accessible thoracic lesions: a case series

2020 ◽  
Vol 13 (12) ◽  
pp. e239170
Author(s):  
David Quigley ◽  
Parthiban Nadarajan ◽  
Finbar O Connell
Keyword(s):  
Diagnostic Yield ◽  
Case Series ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
High Likelihood ◽  
Ultrasound Guided ◽  
Upper Airways ◽  
Ct Guided ◽  
Appropriate Treatment ◽  
Ct Guided Biopsy

Endobronchial ultrasound (EBUS) has long been a common diagnostic tool used in the diagnosis of pulmonary pathologies. In the last decade, increased interest has been shown in its usage via the oesophagus for sampling lesions inaccessible via the airways. We describe three cases in which we used this modality to biopsy lesions not visualised via conventional EBUS and which would be too risky to be attempted via a CT-guided biopsy with a high likelihood of complications. More focused education on using EBUS via the oesophagus for respiratory trainees could greatly improve overall clinical practice. It improves the diagnostic yield of lesions and prevents subsequent referral to gastrointestinal colleagues which may delay diagnosis especially during the COVID-19 pandemic as was the case in our patient cohort where services are already limited. EBUS, due to its smaller size, is less irritant to the upper airways and requires less sedation than endoscopic ultrasound (EUS) scopes. It is also shorter than an EUS scope improving manoeuvrability. Each of our cases resulted in early histological diagnosis and subsequent appropriate treatment.

The Techniques of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

2011 ◽  
Vol 6 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Takahiro Nakajima ◽  
Kazuhiro Yasufuku
Keyword(s):  
Lymph Node ◽  
Diagnostic Yield ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Lymph Node Staging ◽  
Ultrasound Guided ◽  
Surgical Biopsy ◽  
Transbronchial Needle Aspiration ◽  
High Diagnostic Yield

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality for mediastinal lymph node staging in lung cancer patients as well as for the diagnosis of mediastinal and hilar adenopathy. The high diagnostic yield of EBUS-TBNA for lymph node staging has been shown in systematic reviews and meta-analysis. It has attracted physicians and surgeons as an alternative modality to surgical biopsy for the assessment of patients with enlarged mediastinal and/or hilar lymph nodes. Cell blocks obtained by EBUS-TBNA can be applicable not only for pathologic diagnosis but also for further investigations such as immunohistochemistry and fluorescence in situ hybridization. In addition, samples obtained by EBUS-TBNA can also be used for molecular analysis. Unlike regular bronchoscopy, EBUS-TBNA uses the convex probe EBUS with an ultrasound probe on the tip of a flexible bronchoscope. It is important for the bronchoscopist to fully understand the mediastinal anatomy and be able to correlate it with the ultrasound images for a successful EBUS-TBNA. The dedicated transbronchial needle used for EBUS-TBNA is somewhat different from an ordinary transbronchial biopsy forceps. Training is mandatory for achieving high diagnostic yield without complications. The learning curve of EBUS-TBNA is different from each physician, and continuous training program will be needed for impartiality. This article explains the detailed techniques of EBUS-TBNA to master this innovative procedure.

Ultrasound-guided percutaneous biopsy of thoracic lesions: high diagnostic yield and low complication rate

2021 ◽  
Author(s):  
E. Portela-Oliveira ◽  
C.A. Souza ◽  
A. Gupta ◽  
H. Bayanati ◽  
J. Inacio ◽  
...  
Keyword(s):  
Complication Rate ◽  
Diagnostic Yield ◽  
Percutaneous Biopsy ◽  
Ultrasound Guided ◽  
High Diagnostic Yield

Ultrasound core biopsies of neck lumps: an experience from a tertiary head and neck cancer unit

2021 ◽  
pp. 1-5
Author(s):  
M Adeel ◽  
R Jackson ◽  
T Peachey ◽  
N Beasley
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Core Biopsy ◽  
Diagnostic Yield ◽  
Excisional Biopsy ◽  
Disease Recurrence ◽  
Needle Aspiration ◽  
Safe Procedure ◽  
Ultrasound Guided

Abstract Background Traditionally, fine needle aspiration cytology was the primary diagnostic investigation for head and neck lumps; however, ultrasound-guided core biopsy offers the advantage of preserving tissue architecture with increased tissue yield. This study reviews the diagnostic utility of ultrasound-guided core biopsy for investigating head and neck lumps. Methods Overall, 287 ultrasound-guided core biopsies were reviewed between May 2017 and April 2019 at a single tertiary site for head and neck cancer. Results On initial ultrasound-guided core biopsy, a diagnostic sample was obtained in 94.4 per cent of patients and in 83.7 per cent of patients with lymphoma. Where the initial ultrasound-guided core biopsy was non-diagnostic, 50 per cent of samples were diagnostic on repeat ultrasound-guided core biopsy. Overall, five complications were seen related to ultrasound-guided core biopsy, and all were managed conservatively. No cases of disease recurrence were identified at the biopsy site. Conclusion Ultrasound-guided core biopsy is a safe procedure with a high diagnostic yield when investigating head and neck lumps. Patients whose ultrasound-guided core biopsies were non-diagnostic should be considered for excisional biopsy over repeat ultrasound-guided core biopsy.

scholarly journals Role of Computed Tomography Guided Fine-Needle Aspiration Cytology in the Study of Various Thoracic Mass Lesions

2021 ◽  
Vol 10 (18) ◽  
pp. 1269-1274
Author(s):  
Nawanita Kumari ◽  
Nidhish Kumar ◽  
Sharvani Singh ◽  
Vishal Vaibhaw
Keyword(s):  
Computed Tomography ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Ct Guided ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Intrathoracic Mass ◽  
Mass Lesions

BACKGROUND Intrathoracic mass is a problem faced by the clinicians worldwide which is difficult to diagnose correctly. The mediastinum although a small anatomic compartment, the pathologic processes found in it are diverse. Imaging techniques are very helpful for detection and diagnosing these lesions. The current study was conducted for assessing the diagnostic accuracy and efficacy of computed tomography (CT) guided fine-needle aspiration cytology (FNAC) in the evaluation of various thoracic mass lesions and also to compare the histopathological findings of CT guided FNAC for evaluation of the type of thoracic lesions & its prognosis. METHODS Data for the study was collected from 50 patients referred to the Department of Pathology, in a tertiary care hospital for 16 months from December 2015 to March 2017. RESULTS Among 50 patients with intrathoracic mass, there were 37 men (74 %) and 13 women (26 %). The age of patients with intrathoracic masses in this study varied from 31 to 80 years. The mean age was 55 years. Thirty-two patients were found to have malignant tumours and 18 cases were of benign aetiology. The highest frequency of cases in this study were of adenocarcinoma followed by squamous cell carcinoma. CONCLUSIONS Computed tomography (CT) guided fine-needle aspiration cytology (FNAC) is a cost effective, simple, safe, highly sensitive & specific procedure with high diagnostic accuracy in the diagnosis of intrathoracic mass lesions. It has few complications, rarely requiring active management. KEY WORDS Intrathoracic Mass, Fine-Needle Aspiration Cytology, Pneumothorax, Pneumonectomy, Thoracic Mass Lesions

Ultrasound-guided percutaneous rib biopsy: a safe procedure with high diagnostic yield

2019 ◽  
Vol 74 (8) ◽  
pp. 650.e1-650.e6
Author(s):  
J.W. Huang ◽  
C. Souza ◽  
Z. Jibri ◽  
K.S. Rakhra
Keyword(s):  
Diagnostic Yield ◽  
Safe Procedure ◽  
Ultrasound Guided ◽  
High Diagnostic Yield

scholarly journals High diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of adolescent pulmonary tuberculosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne Geweniger ◽  
Ales Janda ◽  
Kristin Eder ◽  
Roland Fressle ◽  
Cecil Varna Kannan ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Yield ◽  
Pediatric Population ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Pulmonary Tb ◽  
High Diagnostic Yield ◽  
Sampling Procedures

Abstract Background The microbiological diagnosis of pulmonary tuberculosis (Tb) in a pediatric population is hampered by both low pathogen burden and noncompliance with sputum sampling. Although endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been found useful for the evaluation of mediastinal pathologies in adults, for children, sparse data are available. Here, we have evaluated EBUS-TBNA as a diagnostic procedure in children and adolescents with suspected pulmonary Tb. Methods In this retrospective analysis, we reviewed the charts of unaccompanied refugee minors (URM) who were admitted between January 2016 and July 2018 and who, during their initial medical screening upon arrival in Germany, were found to have abnormal radiological pulmonary and mediastinal findings and/or immunological results indicative of Tb. For each patient, basic sociodemographic data, clinical features and data on diagnostic procedures performed were assessed. These included imaging, immunodiagnostic tests and microbiological data derived from sputum, bronchoalveolar lavage, EBUS-TBNA, bronchoscopy and pleural fluid sampling. All patients who underwent invasive sampling procedures were included in the study. Results Out of 42 URM with suspected Tb, 34 fulfilled the study’s inclusion criteria. Ages ranged from 14 to 17 years. All were of African origin, with 70.0% coming from Somalia, Eritrea and Ethiopia. Among the 21 patients for whom EBUS-TBNA was performed, the diagnostic yield was high: 66.7% positive results (MTb detected either by acid-fast stain, culture or PCR in 4.8, 42.9 and 61.9% of samples, respectively). Multidrug-resistant MTb was found in two patients from Somalia. No complications were associated with the procedure. Overall, pulmonary Tb was diagnosed in 29 patients (85.3%), miliary Tb in two patients (5.9%) and latent Tb in three patients (8.8%). Conclusions EBUS-TBNA is a sensitive and safe method with high diagnostic yield in the evaluation of pediatric patients with mediastinal pathology and suspected Tb.

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