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Neumología y cirugía de tórax

versión impresa ISSN 0028-3746

Resumen

GUTIERREZ-CAMACHO, Eduardo et al. Utility of lung transthoracic biopsy with Tru-cut and Chiba needle on the same patient, guided by CT for periferial lung tumor diagnosis. Neumol. cir. torax [online]. 2019, vol.78, n.2, pp.116-121.  Epub 09-Dic-2020. ISSN 0028-3746.

Transthoracic lung biopsy (TTLB) with fine needle Chiba type and Tru-cut thick cutting biopsies, computerized tomography (CT) scan guided lung biopsies in the diagnosis of peripheral lung lesions.

Objective:

Compare the diagnostic certainty (TTLB) with Chiba and Tru-cut biopsy in the same patient, and evaluate if the combination of both improves the certainty in the diagnosis, without increasing complications.

Material and methods:

Forty-nine adult patients with pulmonary lesions were studied from April 2013 to April 2016 at a 2nd level hospital. All patients were biopsied a Chiba needle, followed by a Tru-cut which were analyzed by 2 different pathologists.

Results:

Two patients were eliminated due do not having complete results. Of the 47 studied patients 34 (72%) were male and 13 (28%) female, their age range was 42-86 and average 68.9 years old. With the Chiba technique, 95% of the patients were diagnosed: 41 malignant, 4 benign and 2 false negatives that required minor surgery (thoracoscopy and mini-thoracotomy) for diagnosis. With Tru-cut, 87%: 38 malignant, 9 negative to malignancy: 9 benign (2 of them were malignant with Chiba) and 5 false negatives (3 malignant with Chiba and 2 minor surgery); and 4 bening pathologies (2 infections, 1 hamartoma and 1 pulmonary atelectasis). Most frequent histological types in both techniques were epidermoid and adenocarcinoma. The benign causes were: Hamartoma, infectious and lung atelectasis. The Chiba reported sensitivity 0.95, specificity 1, VPP1, NPV 0.66, false negatives 0.04. The Tru-cut was 0.89, 1.1, 0.44 and 0.11 respectively. Neither technique gave false positives. The main complication was pneumothorax.

Conclusions:

The Chiba needle was slightly superior to Tru-cut in diagnostic certainty. The employment to technique followed the other in the same patient, increased the certainty of the diagnostic, but not the complications.

Palabras llave : Transthoracic lung biopsy; computerized tomography; needle Chiba; needle Tru-cut; diagnostic certain.

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