Biomedical subjects

S H Kuo

Publications and source records attributed to S H Kuo.

At least 73 records · Page 4Linked to original sources

PubMed1994

Correlation of flow cytometric and microdensitometric DNA content analysis in lung cancer.

The DNA histograms of 29 histologically verified primary lung cancers were analyzed with flow cytometry and microdensitometry. Fresh tumor tissues were imprinted on the slide and air dried for modified Feulgen staining. Then the smears were scanned with a scanning microdensitometer at a wavelength of 550 nm. The S-phase fraction value was estimated from the DNA histogram with a cumulated probability scale. The remaining parts of the tumors were minced and prepared for dispersal as a single cell suspension for propidium iodide staining. The tumor cells were then analyzed with a flow cytometer at 488 nm. The correlation between the analyses measured with these two methods showed r = .75 for the DNA index, r = .71 for the S-phase fraction and r = .61 for the G0G1 population; P < .001. The DNA indices, S-phase fraction values and G0G1 populations obtained with flow cytometry and microdensitometry correlated well.

Adenocarcinoma↗

PubMed1994

Nuclear area and DNA content in tumor and nontumor portions of hepatocellular carcinoma.

The nuclear area and DNA content between tumor and nontumor portions of hepatocellular carcinoma (HCC) were compared. Thirty pairs of imprint smears were made from surgical specimens and stained with a modified Feulgen reaction. Two hundred nuclei were scanned with a microdensitometer at a wavelength of 550 nm. DNA histograms were plotted with lymphocytes as the internal control. Nuclear areas of 200 cells in each case were measured with Minimagiscan image analyzer. Hyperploidy (DNA index > 1.1) was 76.7% and 53.3% in tumor and nontumor portions, respectively. The S-phase fraction value was 7.9 +/- 3.5% (+/- SD) and 4.1 +/- 2.4% in tumor and nontumor portions of HCC (P < .001). The mean nuclear area of the tumor portion was significantly larger than that of its corresponding nontumor portion (232.9 +/- 68.1 vs. 137.6 +/- 15.5 microns2, P < .001). Marked anisonucleosis was found in both the tumor and nontumor portions of HCC. The mean coefficient of variation of mean nuclear areas was 27.8 +/- 10.4% and 22.9 +/- 4.9% in the tumor and nontumor portions, respectively (P < .05). DNA ploidy correlated well with mean nuclear area in the tumor portions (r = .730) but not in the nontumor ones. The results indicate that the three most important cytologic criteria of malignant cells--hyperchromatism, nuclear enlargement and anisonucleosis--are evident in both the tumor and nontumor portions of HCC.

Adult↗

PubMed1994

[Evaluation of yellow IRIS/model 450 for routine urinalysis].

BACKGROUND: Urinalysis yields a great deal of information quickly and economically for detection of renal diseases. The inter-technician variation and time consuming are major problems while processing large amount of specimens. The purpose of this study is to evaluate the benefit of an automated urine analyzer, Yellow IRIS/model 450, and the feasibility of replacing the currently-used manual KOVA method. METHODS: A total of 1,000 random urine specimens were analyzed with Yellow IRIS and KOVA method. Precision, correlation, and detection rate of abnormality were compared between these two methods. RESULTS: The results revealed that Yellow IRIS had high precision with little between-run and within-run variation, while the obtained values were notably highly correlated with the expected values (r = 0.99). In addition, detection rate of blood cell abnormalities for the Yellow IRIS was twice better than for the manual KOVA method. CONCLUSIONS: The high precision of the machine, the simple procedure of performing, and the quickness of obtaining data, can minimize variability caused by the manual method and save processing time for mass screening. It is feasible to replace the manual urinalysis by the automated urine analyzer Yellow IRIS. Nevertheless, to minimize the extent of manual manipulation, including pouring the urine into the pour cup, and placement of the urine strip, will assist in a wider acceptance for the Yellow IRIS/Model 450.

Autoanalysis↗

PubMed1993

Diagnosis of pulmonary cryptococcosis by ultrasound guided percutaneous aspiration.

BACKGROUND: Ultrasound is useful for locating thoracic lesions and guiding biopsy procedures. The use of sonographic appearances and ultrasound guided needle aspiration has led to the diagnosis of pulmonary cryptococcosis at this hospital. METHODS: Six hundred and eight patients who had ultrasound guided lung aspirations were reviewed retrospectively and nine with documented pulmonary cryptococcosis were collected. All patients had nodules or infiltrates on the chest radiograph. The needle aspirates obtained under ultrasound guidance were stained by Riu's or Papanicolaou's method or with India ink, and six were sent for culture. Five patients also underwent bronchoscopy and biopsy. RESULTS: The nine patients had 18 pulmonary lesions, of which 15 were nodules and three infiltrates. Fifteen lesions were detectable by ultrasound, which showed the nodules to be hypoechoic with eccentrically located air echoes. In eight of the nine cases cryptococci were detected after the lung aspirates had been stained with Riu's or Papanicolaou stain or with India ink. In five of the six aspirates sent for fungal culture Cryptococcus neoformans was isolated. The diagnostic yield was higher than that of bronchoscopy. None developed post-aspiration pneumothorax or any evidence of late dissemination. CONCLUSIONS: Because they tend to be subpleural pulmonary cryptococcal lesions seem to be identifiable by ultrasound. Ultrasound guided lung aspiration is an effective, rapid, and safe method for diagnosis.

Adult↗

PubMed1993

Ultrasound guided aspiration biopsy for pulmonary tuberculosis with unusual radiographic appearances.

BACKGROUND: Pulmonary tuberculosis can produce unusual radiographic appearances and negative results of sputum and bronchoscopic examinations are common. This study assessed the value of ultrasound guided aspiration biopsy in the diagnosis of pulmonary tuberculosis with unusual radiographic appearances. METHODS: Thirteen patients, ultimately diagnosed as having tuberculosis, underwent a chest ultrasonographic examination between June 1984 and August 1991. All had sputum available for examination and nine were also examined by bronchoscopy. Ten patients who had a negative sputum smear and negative bronchoscopic brushing smears underwent ultrasound guided aspiration or biopsy. Percutaneous aspiration was performed with a 22 gauge needle. If the smear did not reveal acid fast bacilli, a biopsy sample was taken with a 16 gauge Tru-cut needle to obtain a histological diagnosis. RESULTS: The ultrasonographic examination delineated the more complex nature of the lesions better than the chest radiograph. Ultrasound guided aspiration biopsy provided the diagnosis in nine of 10 patients, while the sputum smear and culture provided diagnosis in five of 13, and bronchoscopy in four of nine. In terms of rapid diagnosis, ultrasound guided aspiration biopsy gave the diagnosis in eight of 10 cases. No patient developed a major complication. CONCLUSION: Ultrasonography can direct the needle to the most suitable part of a lesion to obtain the relevant specimens. The diagnostic yield is high and the procedure is relatively safe. It is especially helpful in patients with negative results of sputum and bronchoscopic examinations.

Adolescent↗

PubMed1993

Ultrasound study in unilateral hemithorax opacification. Image comparison with computed tomography.

The diagnostic capability of chest ultrasonography was assessed for use in evaluation of patients presenting with opacification of unilateral hemithorax on chest radiography. Hemithorax opacification provided an "ultrasonic window" for ultrasonic wave penetration to detect any underlying diseases. Fifty patients were included over a study period of 24 months. All had received both chest ultrasonography (US) and computed tomography (CT) examinations, and their underlying diseases had been confirmed by various methods. Comparisons between the findings of chest US and of CT were made in three compartments: pleura, parenchyma, and mediastinum. Diagnostic sensitivity and specificity of chest US was defined by using CT as the "gold standard." The ability of US to detect underlying diseases was comparable to that of CT in pleural and parenchymal lesions. But US was inferior to CT for demonstration of mediastinal lesions. The diagnostic sensitivity of US was 95.1% in pleural lesions, 82.8% in parenchymal lesions, and only 30% in mediastinal lesions. US missed 14 lesions demonstrated by CT (seven mediastinal lesions, five parenchymal tumors, and two pleural nodules), but it showed six lesions that CT had failed to detect (four focal pleural thickening and two parenchymal tumors). US-related procedures were performed (thoracentesis in 33 patients, pleural biopsy in 10 patients, and US-guided aspiration/cutting biopsy in 11 patients) with a high diagnostic yield and no complications. The conclusion was that chest ultrasonography is useful, particularly as a first-step examination for patients with total or nearly total opacification of the hemithorax.

Adolescent↗

PubMed1993

Needle aspiration biopsy of malignant lung masses with necrotic centers. Improved sensitivity with ultrasonic guidance.

False-negative results from transthoracic needle aspiration biopsy of malignant lung masses may occur if a central necrotic area is present and is the source of the biopsy material. The purpose of this study is to determine if the use of ultrasonic guidance can improve the sensitivity of lung needle biopsies in this circumstance. Sixty patients with malignant lung masses underwent ultrasonic examination in an 18-month period. In 14 cases, ultrasound showed that the mass had a large central necrotic area that was at least half the diameter of the tumor. Under ultrasonic guidance, needle biopsy specimens were taken from the central necrotic area and from the tumor wall in each case. Adequate biopsy specimens were obtained in all 14 patients. In all cases, the mural biopsy material was diagnostic for malignant tumor, while the biopsy specimen from the necrotic center was nondiagnostic in 10 of 14 patients. No complications occurred. We conclude that ultrasonically guided lung biopsy is a useful and safe tool to avoid false-negative needle biopsy specimens in malignant lung tumors with necrotic centers.

Adenocarcinoma↗

PubMed1993

Ultrasonography and color Doppler imaging of metastatic pulmonary choriocarcinoma.

Chest ultrasound and color Doppler flow imaging were used to assess the pulmonary nodule of a 24-year-old pregnant woman with dyspnea and hemoptysis. The ultrasonogram showed multiple hypoechoic subpleural nodules. Color Doppler imaging of the nodules revealed characteristics of high vascularity and high blood flow. A percutaneous needle aspiration under ultrasonic guidance confirmed the diagnosis of choriocarcinoma.

Adult↗

PubMed1993

Comparison of DNA stemline and cell kinetics between primary breast cancer and its lymph node metastasis.

Quantitative measurement of nuclear DNA in individual cells was performed on imprint smears of surgical specimens from 25 primary breast cancers and their concurrent regional lymph node metastases (LNMs). Twenty-five paired imprints taken from primary tumors and their LNMs were stained with the modified Feulgen method. The DNA content was measured with a scanning microdensitometer at a wavelength of 550 nm. The status of estrogen receptors in the primary tumor was measured with the charcoal-dextran-coated method. The DNA modal values were identical in 22 (88%) of 25 paired imprints. Among 13 estrogen receptor-positive (ER[+]) tumors, the DNA modal values were diploid or near-diploid (< 2.5C) in 8 (62%) primary tumors and 7 LNMs. In 10 estrogen receptor-negative (ER[-]) tumors, only 1 (10%) LNM had a near-diploid DNA modal value; all others were aneuploid. In primary tumors the DNA modal values of ER(+) tumors were significantly different from those of ER(-) tumors. The S-phase fraction value of a primary tumor correlated significantly with that of its LNMs. The percentage of cells with DNA content > 6.0C correlated highly between the primary tumor and its LNM. Of primary tumors, ER(-) tumors had more cells with high DNA content (> 6.0C) than ER(+) tumors did. A great similarity in cumulative DNA histograms between primary tumors and their LNMs was found, irrespective of the status of estrogen receptors. In conclusion, the primary breast cancer and its LNM had similar DNA distribution patterns--e.g., DNA modal value, S-phase fraction value and percentage of cells with high DNA content.(ABSTRACT TRUNCATED AT 250 WORDS)

Aneuploidy↗

PubMed1992

Ultrasonography and ultrasonographically guided fine-needle aspiration biopsy of impalpable cervical lymph nodes in patients with non-small cell lung cancer.

BACKGROUND: Neck ultrasonography (US) and ultrasonographically guided fine-needle aspiration (UGFNA) cytologic examination were used in the staging work-up of 51 consecutive patients with non-small cell lung cancer (NSCLC) with clinically impalpable cervical lymphadenopathy. METHODS: All patients had chest radiography, fiberoptic bronchoscopic examination, computed tomography (CT) scans of the chest and abdomen, bone scan, and US of the abdomen and the neck. RESULTS: Six patients (12%) were found to have cervical lymph nodes by neck US. The cytologic examination of the lymph node aspirates obtained from UGFNA confirmed the metastasis. The clinical stage thus was changed from Stage IIIa to Stage IIIb in one patient. In the other five patients, UGFNA of cervical lymph nodes prevented more invasive diagnostic procedures. CONCLUSIONS: This preliminary study shows that neck US and UGFNA of lymph nodes may be helpful in the pretreatment evaluation of patients with NSCLC with impalpable cervical lymph nodes. However, additional study is needed to confirm this result.

Adenocarcinoma↗

PubMed1992

Ultrasonographically guided biopsy of thoracic tumors. A comparison of large-bore cutting biopsy with fine-needle aspiration.

A prospective study to compare the safety and diagnostic accuracy of ultrasonographically guided transthoracic large-bore cutting biopsy histologic examination with fine-needle aspiration cytologic examination was conducted in 149 patients with thoracic tumors (29 mediastinal tumors and 120 pulmonary masses). The authors found that large-bore cutting biopsy under ultrasonographic guidance could be as safe as fine-needle aspiration, whereas diagnostic accuracy was significantly higher (97% versus 59% in malignant tumors, respectively, P less than 0.05; 85% versus 33% in benign lesions, respectively, P less than 0.05). The size, depth, and location of lesions did not influence the results of transthoracic needle aspiration or cutting biopsy. In 77 patients with primary lung cancer, fine-needle aspiration cytologic examination, although achieving 88% positive cytologic results, identified the histologic cell type accurately in only 70%, whereas Tru-Cut (Top Surgical, Tokyo, Japan) biopsy was 97% accurate in confirmative histologic diagnosis. Fourteen patients had discordant cytologic and histologic diagnoses, and the cases of 3 (3.9%) were between small cell lung cancer and non-small cell lung cancer. The diagnostic accuracy of Tru-Cut biopsy also was significantly higher than that of fine-needle aspiration in metastatic cancers (90% versus 33%, respectively) and mediastinal tumors (100% versus 46%, respectively). The authors conclude that transthoracic cutting biopsy under ultrasonographic guidance is safe and has a higher diagnostic accuracy as compared with fine-needle aspiration. This technique is particularly useful for benign lesions or tumors with pleomorphic morphologic characteristics, such as lymphomas and thymomas.

Adult↗

PubMed1992

Comparison of OK-432 and mitomycin C pleurodesis for malignant pleural effusion caused by lung cancer. A randomized trial.

A prospective randomized study to compare the effectiveness of pleurodesis by two new sclerosing agents: OK-432 and mitomycin C were conducted in 53 patients with malignant pleural effusion caused by lung cancer. None of the patients received concomitant systemic chemotherapy or radiation therapy during the study. After complete drainage of pleural fluid, the patients were allocated randomly to receive 10 Klinische Einheit units of OK-432 or 8 mg of mitomycin C by intrapleural injection at weekly intervals. The treatment was terminated if the pleural effusion disappeared or the patients had received four consecutive procedures. There were 26 patients who received pleurodesis with OK-432 and 27, with mitomycin C. Patient characteristics in the two treatment groups (age, sex, histologic type, performance status, and prior treatment before pleurodesis) were compatible. These results showed that pleurodesis with OK-432 achieved a higher complete response rate (73%) than that of mitomycin C (41%). The rates of objective treatment response (complete response plus partial response) were comparable in both groups (88% for OK-432 and 67% for mitomycin C). The average number of intrapleural injections needed to achieve complete response was fewer in the OK-432 group (1.9 +/- 0.9) than in mitomycin C group (2.8 +/- 0.9). There was no significant difference in the median survival of the patients who received pleurodesis with OK-432 (5.8 months) or mitomycin C (5.1 months). However, the effusion-free period in the OK-432 group was significantly longer than that in the mitomycin C group (7.0 months versus 1.5 months). Patients who underwent OK-432 pleurodesis had a higher complication rate (80%) than did those in the mitomycin C group (30%). Transient febrile reaction was the most common reaction encountered. The immunologic study in OK-432 group showed an increase in peripheral leukocyte count and decrease in the OKT4/OKT8 ratio. The mitomycin C group had a mild reduction in peripheral blood leukocyte count and no significant change in the OKT4/OKT8 ratio. It was concluded that pleurodesis with OK-432 is an effective alternative treatment for malignant effusion in patients with lung cancer.

Adenocarcinoma↗

PubMed1992

Mediastinal malignancy: ultrasound guided biopsy through the supraclavicular approach.

BACKGROUND: Malignancies located in the upper middle mediastinum usually do not have a sufficiently large acoustic window to permit a conventional ultrasound guided parasternal biopsy. This study was concerned with an alternative approach whereby ultrasound is applied through the supraclavicular paratracheal window to allow percutaneous biopsy of middle mediastinal malignancies. METHODS: Fifteen patients who had upper mediastinal malignancies not in contact with the chest wall underwent real time and Doppler ultrasonographic studies by the supraclavicular approach. None of these tumours could be reached by conventional ultrasound guided parasternal biopsy. The ultrasound was scanned downwards through the supraclavicular fossa, along the acoustic window of the paratracheal soft tissue space. Percutaneous aspiration biopsy was performed with a 22 gauge needle under ultrasound guidance. If fine needle aspiration could not obtain an adequate tissue smear an 18 gauge Trucut biopsy was performed to obtain a histological diagnosis. RESULTS: Twelve of 15 mediastinal malignancies were detected by ultrasound through the supraclavicular approach. These 12 patients underwent percutaneous needle aspiration biopsy under ultrasound guidance. Four of the patients also had a Trucut biopsy because the needle aspirates from the tumours were inadequate. The needle had to pass through the jugular veins in four patients who received fine needle aspiration but in none of the patients who required a Trucut biopsy. Definite histological diagnoses were obtained in all 12 of these patients. Ten of the tumours were malignant and two benign. None of the patients developed any complication. CONCLUSIONS: Ultrasound and ultrasound guided biopsy through the supraclavicular paratracheal window provides a new approach for malignancy located in the upper middle mediastinum, which cannot be reached by conventional ultrasound guided parasternal biopsy. The diagnostic yield of this technique is high and the procedure is relatively safe.

Adenocarcinoma↗

PubMed1992

Ultrasound guided percutaneous cutting biopsy for the diagnosis of pulmonary consolidations of unknown aetiology.

BACKGROUND: Ultrasound has been used to guide percutaneous aspiration biopsy of thoracic tumours with high diagnostic yield. This study assessed the diagnostic value of ultrasound guided percutaneous cutting biopsy for pulmonary consolidation of unknown aetiology. METHODS: Thirty patients with undiagnosed lobar or segmental consolidation underwent ultrasound guided percutaneous needle aspiration and large bore cutting biopsy. The needle aspirates and biopsy specimens were sent for cytological, microbiological, and histopathological examination. RESULTS: Percutaneous needle aspiration provided a diagnosis in nine of 30 patients (30%), whereas cutting biopsy obtained a satisfactory specimen for histological diagnosis in 28 patients (93%) and provided a definite aetiological diagnosis in 17 patients (57%). The combination of needle aspiration with Trucut biopsy provided a diagnostic rate of 63%. The underlying diagnoses were fungal pneumonia (five patients), tuberculosis (five), bacterial pneumonia (one), bronchioloalveolar carcinoma (three), lymphoma (two), adenocarcinoma (one), vasculitis (one), acute pneumonia of unknown aetiology (one), and chronic non-specific pneumonia (nine). Two patients, who had necrotic tissue only in the biopsy specimen, were found at thoracotomy to have an adenocarcinoma and aspergillosis. Two patients had complications from the technique, a small pneumothorax in one and a small haemoptysis in another. CONCLUSIONS: Ultrasound guided percutaneous cutting biopsy is a valuable method for diagnosing pulmonary consolidation of unknown aetiology. The diagnostic yield is high and the procedure appears to be relatively safe.

Adult↗

PubMed1992

Ultrasonographic evaluation of pulmonary consolidation.

A total of 161 patients with lobar or segmental consolidation were examined by realtime ultrasound and Doppler ultrasound. Air bronchograms were detected in 141 patients, fluid bronchograms in 27 patients, and parapneumonic effusion in 74 patients. In 36 patients with necrotizing pneumonia, ultrasound detected microabscesses in 33 (91.7%) compared with the air-fluid levels detected by standard chest radiographs in 20 patients (55.6%; p less than 0.05). Of 31 patients with tumors causing obstructive pneumonitis, 29 (93.5%) had tumors detected by chest ultrasound, whereas only 11 patients (35.5%) had chest radiographs that suggested a tumor was causing the obstructive pneumonitis (p less than 0.05). Chest ultrasound was used to guide thoracentesis for parapneumonic effusion in 65 patients, with a 100% success rate. Twenty-six patients with necrotizing pneumonia underwent ultrasound-guided needle aspiration of microabscesses. The procedure was successful in 24 patients (92.3%), and 21 patients (80.8%) had microbiologic confirmation. Twenty patients with tumor-associated obstructive pneumonitis received needle aspiration biopsy under ultrasound guidance; 19 patients (95.0%) had the histology confirmed. Five patients with malignancy manifesting as pulmonary consolidation underwent a diagnostic ultrasound-guided needle aspiration biopsy. Five patients (3.8%) developed complications of minimal pneumothorax or mild hemoptysis in 132 episodes of needle aspiration. We conclude that ultrasonography is useful for the evaluation of pulmonary consolidation. It can also be used for needle aspiration guidance for etiologic diagnosis of patients with complicated pneumonia.

Adolescent↗

PubMed1992

Ultrasound-guided core biopsy of thoracic tumors.

Two hundred and eighteen patients, with thoracic tumors larger than 3 cm in size, underwent ultrasound-guided percutaneous transthoracic core biopsy with a large-bore Tru-Cut needle. Fifty-five tumors were in the mediastinum, and 122 tumors were located at subpleural area, and 42 tumors were within the lungs. In 122 subpleural tumors, the sensitivity of ultrasound-guided core biopsy for the diagnosis of malignancy was 96.8%, and accuracy was 97.5%. Sensitivity for the diagnosis of malignant tumors located within the lungs was 94.6%, and accuracy was 95.2%. In 54 patients with mediastinal tumors, definite histologic diagnosis could be obtained in 48 patients (88.9%). The sensitivity of ultrasound-guided biopsy for the diagnosis of malignancy in these 48 mediastinal tumors was 97.1%, with an accuracy of 97.9%. Three patients had complications with minimal pneumothorax and one with mild hemoptysis. We conclude that percutaneous transthoracic core biopsy with Tru-Cut needle under ultrasound guidance is a safe and sensitive way to obtain specimens for accurate histologic diagnosis of thoracic tumors. The diagnostic yield is high, and the technique, relatively simple, can also be used for outpatients.

Adolescent↗

PubMed1992

Immunocytochemistry and ELISA quantitation of mucin for diagnosis of malignant pleural effusions.

One hundred and thirty-five pleural effusions with definite etiology were analyzed by mucin-specific monoclonal antibody (17Q2)-derived enzyme-linked immunosorbent assay (ELISA). Twenty-four effusions were transudate, 45 were nonmalignant exudate, and 66 were malignant. Among the 66 malignant effusions, 52 were adenocarcinoma, and 14 were malignancies other than adenocarcinoma. Purified mucous glycoproteins from sputa of normal subjects were used as ELISA standard. Our results showed that the mean mucin concentration in malignant pleural effusions were significantly higher than that of benign exudates (8.41 +/- 13.48 ng/ml versus 1.09 +/- 0.82 ng/ml, p < 0.01). Mucin concentration in malignant pleural effusions caused by adenocarcinoma was also significantly higher than in non-adenocarcinoma effusions (9.96 +/- 14.81 ng/ml versus 2.66 +/- 1.74 ng/ml, p < 0.01). With the use of mean +/- 2 SD of mucin concentration in benign exudates as a cut-off value (2.73 ng/ml), the sensitivity of this assay for diagnosis of malignant effusions was 66.7%, specificity was 97.1%, and accuracy was 82.2%. High levels of mucin concentration were more specifically associated with adenocarcinoma. When the mucin concentration in pleural effusions was greater than 5 ng/ml, 93.1% (27/29) of patients were adenocarcinoma. If the mucin concentration was greater than 10 ng/ml, 100% (14/14) of patients were adenocarcinoma. Immunofluorescent staining by mucin-specific monoclonal antibody 17Q2 were also carried out in diastase-treated cell preparations obtained from 22 patients with malignant pleural effusions and 16 benign exudates. Nine of 14 adenocarcinomas (64.2%) were reactive with monoclonal antibody 17Q2, while none of the benign exudates, squamous cell carcinomas, and mesotheliomas were stained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

PubMed1992

Ultrasound-guided aspiration biopsy of small peripheral pulmonary nodules.

We compared the diagnostic yields of ultrasound-guided aspiration biopsy, sputum cytology, and fiberoptic bronchoscopy with biopsy in 30 patients with peripheral pulmonary nodules smaller than 3.0 cm in diameter. Among them, there were 4 minute nodules with diameter less than 1.0 cm, 12 between 1.1 to 2.0 cm, and 14 between 2.1 to 3.0 cm. The final diagnoses in these 30 patients, as confirmed by histologic findings, microbiology, and clinical follow-up, revealed 24 malignant lesions and 6 benign. All of these 30 nodules received ultrasound-guided transthoracic fine-needle aspiration biopsy, and confirmative diagnoses were obtained in 27 (90 percent). Twenty-two (92 percent) of 24 patients with malignant nodules had positive cytology for malignancy and 5 (83 percent) of 6 patients with benign lesions had diagnosis made by cytologic and microbiologic examinations. One patient developed asymptomatic pneumothorax after needle aspiration. The size of the lesions did not affect the diagnostic yield and complication rate. None of the lesions was diagnosed by sputum cytology (0 of 19; 0 percent). Two patients had diagnoses obtained by fiberoptic bronchoscopy with biopsy (2 of 10; 20 percent). We conclude that ultrasound-guided aspiration biopsy is a useful and safe method for diagnosis of peripheral pulmonary nodules, even when the size of the nodule is less than 3 cm in diameter. The diagnostic yield far exceeds that which can be obtained by sputum cytology and fiberoptic bronchoscopy with biopsy.

Adult↗