Background: Transthoracic ultrasound (US) has gained popularity as a tool for visualizing pleural effusions and assisting thoracentesis or chest drain placement. In the absence of effusion, US just as well demonstrates solid masses involving or abutting the pleura, yet biopsy of such lesions is not widely performed by chest physicians. Objective: To assess the feasibility and the safety of US-assisted cutting needle biopsy performed by chest physicians in routine practice. Methods: Lesions involving or abutting the pleura ≧20 mm in diameter on US were sampled with a 14-gauge cutting needle under local anesthesia. Biopsy site, needle direction and depth of penetration were determined with US. The procedure was performed without direct US guidance in ‘free-hand’ technique. Results: Ninety-one patients underwent 96 cutting-needle biopsies for suspected peripheral lung tumors (n = 44, 46%), pleural-based (n = 39, 41%), mediastinal (n = 10, 10%), or chest wall lesions (n = 3, 3%), which were single in 71%, multiple in 6% and diffuse in 23%. Sensitivity for malignant neoplasms (n = 65) was 85.5% and 100% for mesothelioma (n = 10). Pneumothorax occurred in 4%. Conclusions: US-assisted cutting-needle biopsy of lesions ≧20 mm in diameter is safe in the hands of pulmonologists. The yield for neoplastic disease including mesothelioma is high.

Keywords:
Lung, biopsy, Mediastinum, biopsy, Mesothelioma, Pleura, biopsy, Ultrasonography
1.
Beckh S, Bolcskei PL, Lessnau KD: Real-time chest ultrasonography: A comprehensive review for the pulmonologist. Chest 2002;122:1759–1773.
2.
Herth FJF, Becker HD: Transthoracic ultrasound. Respiration 2003;70:87–94.
3.
Maskell NA, Gleeson FA, Davies RJO: Standard pleural biopsy versus CT-guided cutting-needle biopsy for diagnosis of malignant disease in pleural effusions: A randomised controlled trial. Lancet 2003;361:1326–1331.
4.
Heilo A, Stenwig AE, Solheim OP: Malignant pleural mesothelioma: US-guided histologic core-needle biopsy. Radiology 1999;211:657–659.
5.
Adams RF, Gray W, Davies RJ, Gleeson FV: Percutaneous image-guided cutting needle biopsy of the pleura in the diagnosis of malignant mesothelioma. Chest 2001;120:1798–1802.
© 2004 S. Karger AG, Basel
2004
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.