Abstract
Background: There is a wide range of tools used in diagnosis of pulmonary nodules localized beyond the range of standard bronchfiberoscope, but is still difficult to choose best method to obtain tissue samples.
Aims and objectives: The aim of our study was to asses safety and utility of methods currently used in Department of Pulmonology in Katowice, Poland, and on the basis of obtained results to prepare diagnostic protocol to be tested in prospective study.
Methods: 93 consecutive patients records (56 females and 37 makes) were analyzed. Included patients had at least one pulmonary nodule exceeding 10 mm in diameter, which on the basis of CT scan was not assessable by standard bronchofiberoscope.
Results: 64 transthoracic biopsies were performed: 40 CT-guided cytological [22 (55%) diagnostic], 20 ultrasound guided cytological [10 (50%) diagnostic] and 4 ultrasound guided histological [all diagnostic] respectively. Pleural fluid was examined 8 times but only one pleurocentesis was diagnostic. Sputum analysis was performed 16 times but all results were not diagnostic. Out of 39 cases in which bronchofiberoscopy was performed 6 (15,9%) were diagnostic. All, except one positive diagnoses were pulmonary cancer. Out of 40 CT guided biopsies 17 (42,5%) were complicated by pneumothorax. In 3 (7,5%) cases drainage was required. Out of 20 ultrasound guided cytological biopsies there was 1 pneumothorax not requiring drainage. There were no observed complications in histological biopsies. The diameter of nodules in patients with positive diagnosis was bigger (p<0,05).
Conclusions: Accurate selection of diagnostic tools seems to be crucial for effective and safe diagnosis of pulmonary nodules.
- © 2011 ERS
