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Why do a lung biopsy for benign lesions?

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Transthoracic needle biopsy of lung lesions can incidentally identify benign conditions. This study found 10% of biopsies revealed benign lesions, including hamartomas and granulomas, which can mimic lung cancer.

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Area of Science:

  • Pulmonary Medicine
  • Diagnostic Imaging
  • Pathology

Background:

  • Transthoracic needle biopsy (TTNB) is standard for lung lesion diagnosis, with high accuracy for malignancy.
  • Literature often emphasizes malignant diagnoses, yet benign lesions are also incidentally found via biopsy.
  • Biopsies for presumed benign lesions occur due to unexpected findings or as a diagnosis of exclusion.

Purpose of the Study:

  • To determine the frequency and types of benign lung lesions diagnosed via TTNB.
  • To identify benign pathologies that may be misdiagnosed as lung cancer on imaging.

Main Methods:

  • Retrospective single-center study of CT-guided lung biopsies from 2015-2019.
  • Analysis of histological data from 969 patients.
  • Focus on benign lesions, detailing imaging features and differential diagnoses with malignancy.

Main Results:

  • Out of 969 biopsies, 93 (10%) revealed benign lesions.
  • Common benign pathologies mimicking lung cancer include hamartomas, granulomas, slow-resolving pneumonia, and cryptogenic organizing pneumonia.

Conclusions:

  • Benign lesions constitute a notable proportion of TTNB findings.
  • Understanding imaging characteristics of these benign lesions is crucial for accurate differential diagnosis with lung cancer.