Use of the Rotex needle in percutaneous biopsy of pulmonary malignancy

When the characteristics of 30 biopsy needles were reviewed in a recent study using cadaveric liver tissue, the Rotex needle was judged to yield notable crush artifact, poor histologic preservation, and small sample specimens. In the current review of the Rotex needle in percutaneous lung biopsy in 121 patients, the authors report 98% sensitivity for the presence of malignancy and 94% specificity for the absence of malignancy. Although the Rotex needle has shown poor results in liver substrate studies, it proved more than adequate for obtaining lung tissue and a subsequent diagnosis of pulmonary malignancy. This apparent contradiction is explained by the fact that the diagnosis of lung malignancy can be made from cytopathologic material and does not require histologic specimens in most cases.