Fine-needle aspiration biopsy of the mediastinum

Fine-needle aspiration is a useful technique to identify neoplasms of many sites, such as breast, thyroid, and lung. Thirty-two mediastinum aspirates from 29 patients were reviewed. Five aspirates yielded insufficient material. Five aspirates were of benign lesions. Four aspirates were suggestive of but not diagnostic of malignancy. Eighteen aspirates contained malignant cells; in 13 of these, a definite cell type was identified, which usually was metastatic lung carcinoma; in five instances, the cell type could not be unequivocally identified. Complications were minimal, two instances of pneumothorax (6.3 percent) and two of hemoptysis (6.3 percent). No deaths or hemorrhage occurred. In 16 of the 29 patients (55 percent), thoracotomy was avoided because of fine-needle aspiration biopsy. It is concluded that fine-needle aspiration biopsy of the mediastinum is a safe, useful diagnostic tool. This procedure may obviate the need for thoracotomy in persons with inoperable cancer, thus lowering medical costs and length of hospital stay.