The Diagnostic Yield and Safety of Ultrasound-Assisted Transthoracic Fine-Needle Aspiration of Drowned Lung
2010; Karger Publishers; Volume: 81; Issue: 1 Linguagem: Inglês
10.1159/000319576
ISSN1423-0356
AutoresCoenraad F.N. Koegelenberg, Chris T. Bolliger, Elvis M. Irusen, Colleen A. Wright, Mercia Louw, Pawel Schubert, Andreas H. Diacon,
Tópico(s)Trauma Management and Diagnosis
Resumo<i>Background:</i> Proximal lung tumors, though not discernable by means of transthoracic ultrasound (US), may cause varying degrees of pulmonary collapse and postobstructive pneumonitis which may give rise to a ‘drowned lung’ appearance on chest computed tomography (CT) and US. The diagnostic yield for malignancy of US-assisted transthoracic fine-needle aspiration (FNA) of these areas of drowned lung is unknown. <i>Objectives:</i> We aimed to explore the feasibility of US-assisted FNA in this setting by prospectively investigating its diagnostic yield and safety. <i>Methods:</i> We enrolled 31 patients (aged 59.4 ± 9.7 years, 17 males) with central tumors and secondary drowned lung on CT scan. A respiratory physician performed transthoracic US to identify the target drowned lung tissue. Three US-assisted superficial FNA passes (≤20 mm from the pleura) were followed by 3 deeper FNA passes (>20 mm) aimed in the direction of a visible or approximated central mass. Rapid on-site evaluation of specimens was used. <i>Results:</i> Superficial FNA was diagnostic in 11 patients (35.5%), whereas deeper FNA was diagnostic in 23 patients (74.2%, p = 0.002). Deeper FNA confirmed malignancy in all cases with diagnostic superficial FNA. We observed no pneumothoraces or major hemorrhage. All patients were ultimately diagnosed with malignancy (bronchogenic carcinoma, n = 30; lymphoma, n = 1). <i>Conclusions:</i> US-assisted FNA of drowned lung has an acceptable diagnostic yield and is safe.
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