Transtorasik Akciğer Biyopsisi: Tek Bir Merkezdeki İlk Deneyimlerin Retrospektif Değerlendirmesi

Year 2022, , 436 - 442, 28.08.2022

Mahmut Çoraplı , Mustafa Göksu , Hüseyin Alakuş , Hacı Taner Bulut , Ömer Cenap Gülyüz Burcin Pehlivanoglu

https://doi.org/10.35440/hutfd.1070659

Abstract

Amaç: Bilgisayarlı tomografi (BT) eşliğinde transtorasik akciğer biyopsisi konusundaki ilk deneyimimizi değerlendirmek ve komplikasyon oranlarımızı vb. sonuçlarımızı literatür ile karşılaştırmak.
Materyal ve Metod: Akciğer lezyonu olan 33 ardışık hastada 15 cm uzunluğunda 16 gauge yarı otomatik (koaksiyel) biyopsi iğnesi kullanılarak BT eşliğinde 34 transtorasik biyopsi işlemi retrospektif olarak değerlendirildi. Yaş, cinsiyet, lezyonun boyutu, yerleşim yeri, plevraya uzaklık, iğne giriş açısı, hasta pozisyonu, amfizem ve / veya komplikasyon varlığı (pnömotoraks ve pulmoner hemoraji), biyopsi öncesi, sırası ve sonrasında radyolojik bulgular değerlendirildi ve patolojik tanılar hasta dosyalarından elde edildi. Yöntemin tanısal başarısı, başarısızlığı ve komplikasyon oranları not edildi.
Bulgular: Pnömotoraks ve pulmoner kanama sırasıyla 9 ve 7 hastada gözlendi ve 4 hastada her ikisi de vardı. Sadece 4 hastada göğüs tüpü uygulaması gerekti (9 hastanın 4'ü pnömotorakslı). Akciğer kanaması olan hastaların hiçbirine ek işlem gerektirmedi. Biyopsi örneği, tanısal doğruluk oranı % 96.6 olup, 32 hastada histopatolojik değerlendirme için yeterliydi. En sık tanı skuamöz hücreli karsinomdu (11/33), bunu 14 hastada diğer primer akciğer tümörleri, 2 hastada meme karsinom metastazı ve 1 hastada B hücreli lenfoma izledi.
Sonuç: BT eşliğinde transtorasik akciğer biyopsisine bağlı komplikasyon oranımız literatür ile benzer oranlardaydı. Pnömotoraks ve pulmoner kanama beşte/dörtte bir kadar hastada ortaya çıkabilir, ancak bu komplikasyonların tedavisi hastaların çoğunda ek prosedürler gerektirmez ve tanısal doğruluk oranı yüksektir.

Keywords

Akciğer, Bilgisayarlı Tomografi, Transtorasik Biyopsi, Tanı, Histopatoloji

Transthoracic Lung Biopsy: A Retrospective Evaluation of the First Experiences in A Single Center

Abstract

Background: To evaluate our first experience on computed tomography (CT)-guided transthoracic lung biopsy and compare our results including complication rates, etc. with the literature.
Materials and Methods: Thirty-four CT-guided transthoracic biopsies in 33 consecutive patients with lung lesions using a 15 cm long 16 gauge semi-automatic (coaxial) biopsy needle were retrospectively evaluated. Age, gender, size of the lesion, location, distance to pleura, needle insertion angle, patient position, presence of emphysema and/or complications (pneumothorax and pulmonary hemorrhage), radiological findings before, during and after the biopsy,and pathological diagnosis were retrieved from patient files. The diagnostic success and failure of the method, and complication rates were noted.
Results: Pneumothorax and pulmonary hemorrhage were observed in 9 and 7 patients, respectively, and 4 patients had both. Application of a chest tube was necessary in only 4 patients (4 of 9 patients wirth pneumothorax). None of the patients with pulmonary hemorrhage required additional procedures. The biopsy sample was adequate for histopathologic evaluation in 32 patients with a diagnostic accuracy rate of 96.6%. The most frequent diagnosis was squamous cell carcinoma (11/33), followed by other types of primary lung tumors in 14, breast carcinoma metastasis in 2, and B-cell lymphoma in 1 patient.
Conclusions: Our rate of complication due to CT-guided transthoracic lung biopsy seems to be comparable with the literature. Pneumothorax and pulmonary hemorrhage may occur in up to one fifth/fourth but the management of these complications does not require additional procedures in the majority of patients, and the diagnostic accuracy rate is high.

Keywords

Lung, Computed Tomography, Transthoracic Biopsy, Diagnosis, Histopathology

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