Aspiration biopsy of thoracic lesions

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Fluoroscopically guided aspiration biopsies of thoracic lesions have been executed for several years and have gained increasing favor with thoracic surgeons and physicians specializing in chest diseases.1–4 At the Cleveland Clinic this method has provided a rapid means of ascertaining the nature of pulmonary nodules and mediastinal masses with exceedingly little trauma and small risk to the patient.5 One of the primary benefits has been the ability to perform the examination on an outpatient basis and later route the patient for definitive therapy, thus either shortening the hospital stay or eliminating it. As a consequence, a significant number of bronchogenic carcinomas have been diagnosed and the patients have been treated without spending a single day in the hospital.5

The primary purpose of the examination is to determine the nature of a solid mass; if it is present in the mediastinum or in the pulmonary parenchyma it is suspected to be a neoplasm. We usually have employed this method to diagnose pulmonary tuberculosis, fungal infections, and specific bacteriologic abscesses, and to prove the presence of localized collections of fluid. We have not been successful in using it to identify lipomas or neural tumors, although this has been described by Dahlgren and Nordenström.1


Routine roentgenographic examinations of the chest are commonly used to identify and localize the lesion. Indeed, many of the solitary nodules in the lung are discovered accidentally in the examination of a patient for another problem which appears unrelated. Laminograms are only occasionally necessary and in the . . .



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