Computed-tomographic-guided biopsy of thoracic nodules: a revision of 583 lesions.

In pulmonary lesions, when bronchial or trans-bronchial biopsy is negative, thoracic Fine-Needle Aspiration Biopsy (FNAB) allows to obtain a cytological or histological diagnosis. The purpose of the current study is to investigate the usefulness of CT-guided FNAB to define the nature of pulmonary or thoracic lesions.Between May 1995 and September 2005, 583 patients (453 males, 133 females), with thoracic lesions, without evident intrabronchial neoplasm, underwent CT-guided FNAB of thoracic nodules. FNAB was performed with 19-20-21 gauge needles, disposable soft tissue, automatic aspiration biopsy Menghini set, 10-15 cm long.In 292 patients (50%) lesions were < or = 3 cm diameter. Post biopsy pneumothorax occurred in 103 (18%) patients, with 29 patients requiring chest tube placement. Post biopsy haemoptysis occurred in 21 (4%) patients, but no patient required treatment for haemoptysis. There were 72 benign lesions (16 neoplasms) and 491 cancers (456 primary, 35 metastasis). Diagnostic accuracy was 93% and sensitivity for malignancy 93%.FNAB has excellent diagnostic rates and is a suitable technique for diagnosing thoracic lesions.