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Ann Med Res. 2005; 12(4): 231-234

Evaluation of Pulmonary Lesions Undiagnosed With CT Guided Transthoracic Fine Needle Aspiration


Mustafa Kürşat Özvaran*, Sibel Arınç*, Özlem Uzman*, İlknur Dilek*, Efsun Uğur Chousein*, Dilay Demiryontar*, Reha Baran*



Objective: This study was planned to evaluate the causes of failure of diagnosis and to determine the route of

diagnosis in patients with pulmonary lesions undiagnosed with Computerized Tomography (CT) guided

Transthoracic Fine Needle Aspiration biopsy (TFNA).

Material and methods: We retrospectively evaluated 673 patients who underwent CT-guided TFNA biopsy between

January 2001 and August 2003.

Results: Diagnosis could not be made in 94 patients with CT guided TFNA biopsy (14%). Diagnosis could be made

in 33 (%35) with thorocotomy, in 11 (%12) with bronchoscopy, in 1(%1) with mediastinoscopy, in 1 (%1) with

biopsy of lymphyadenopathy, in 1(%1) with culture of AFB, and in 39 (%41) with clinical and radiologic follow up.

Diagnosis could not be made 9 (%10) due to lost to follow up. Of the 664 patients, the final diagnosis was

malignant in 597(%90) and benign in 67(%10). Eighty-five patients who had no diagnosis with TFNA were

diagnosed to have malignancy in 49 (58%) malignant and benign lesion in 36 (42%). Eighty-five patients underwent

128 TFNA procedures. The cytology of these procedures included nonspecific blood cells in 86 (67%), reactive cells

in 27(21%), atypical cells in 10 (8%) and benign cells in 5(4%).

Conclusion: Since the 58% of undiagnosed cases was malignant, the diagnosis has to be done in undiagnosed cases,

with clinical suspicion of malignancy. We believe that checking out the adequacy of biopsy specimens during TFNA

procedure will yield higher accuracy and will enable the clinicians to avoid unnecessary thorocotomy procedures for

benign and inoperable pulmonary lesions.

Key Words: CT-Guided, Needle biopsy, Pulmonary lesions, Undiagnosed procedures

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