CT-guided biopsy of the chest: usefulness of fine-needle core biopsy combined with frozen-section pathologic diagnosis.

Abstract

PURPOSE: To improve the diagnostic accuracy of computed tomography (CT)-guided biopsy of the chest. MATERIALS AND METHODS: The usefulness of fine-needle core biopsy combined with immediate frozen-section diagnosis by pathologists was prospectively studied. Fifty-five biopsies of the chest were performed under CT guidance in 55 patients with 36 malignant and 19 benign processes. Initial biopsy was always attempted with a 21-gauge modified Menghini needle; tissue samples were sent to the pathology department immediately after biopsy for pathologic diagnosis of the frozen sections. RESULTS: In 47 of 55 lesions (85%) sufficient materials for diagnosis were obtained and enabled correct final diagnosis. Specific histologic diagnosis was possible in 25 (74%) of 34 malignant and 10 (77%) of 13 benign lesions. In all of the eight other lesions, cytologic diagnosis of aspirated material was correct. No false-positive or false-negative results have occurred. CONCLUSION: Histologic diagnosis with frozen sections improves diagnostic accuracy of chest biopsy; immediate pathologic diagnosis is an encouraged adjunct.