Transthoracic fine-needle aspiration guided by fluoroscopy: validity and complications with 19 operators

During a 3-year period, 19 physicians performed 271 transthoracic fine-needle aspirations (FNA) in 199 patients, using a 23-guage aspiration needle with an 18-guage guiding needle. The diagnosis was confirmed by cytological examination of the needle aspirates in 90 out of 122 patients with malignant tumors, giving a sensitivity of 74%. The specificity of the cytological diagnosis was 100%. Both cytological and histological material was available in 49 patients. The tumor typing from the FNA specimens and the biopsies was in agreement in all but 3 cases. Pneumothorax occurred in 27% of the patients, but only 3.5% required tube drainage. Small variations (p greater than 0.05) in number of diagnostic punctures and rate of complications were evident among the participating physicians and between two fluoroscopic equipments.