[Towards another diagnostic approach of peripheral pulmonary masses in pneumology: ultrasonically guided needle...

In a series of 50 patients with lung lesions touching the thoracic wall, percutaneous ultrasonically guided needle aspiration yielded a pathological diagnosis in 44 cases (sensitivity: 88%). The histological diagnosis of malignant lesion could be confirmed in 41 of these 44 patients. In this group of patients with neoplasia the diagnosis obtained by extemporaneous cytotology was compared with that obtained by lung biopsy: the diagnostic sensitivity of cytology proved to be higher than that of biopsy (86.36% and 65.90% respectively). Using the two methods concomitantly increased sensitivity up to 93.18%. A pathological diagnosis could be obtained in 3 out of the 6 patients in this series who had benign lesions. No bleeding was observed, and there was only one complication: a partial pneumothorax not requiring drainage which was detected by ultrasonography and confirmed by radiography. Thus, ultrasonically guided needle aspiration of lesions adjacent to the thoracic wall appears to be an efficient and reliable diagnostic method. Lack of irradiation, real-time guidance, low cost, high sensitivity and easily available equipment are as many reasons to prefer this method to other interventional radiology methods in patients with peripheral lung masses detectable by ultrasounds.