Sonographically guided needle biopsy for diagnosis of thoracic lesions

Fluoroscopically guided percutaneous biopsy of thoracic lesions is widely accepted. However, some lesions are not sufficiently visible on fluoroscopy. When this is the case, sonographic guidance may be helpful. Real-time sonographically guided needle biopsy was performed in 38 such cases, including 27 pulmonary nodules adjacent to the chest wall, three mediastial tumors, five chest wall masses, and three pleural lesions. Definitive diagnoses were made in 30 cases (78.9%), including 21 (91.3%) of 23 malignancies and nine (60%) of 15 benign lesions. Sonographically guided needle biopsy could be performed safely and easily, taking advantage of the real-time monitoring of needle position for the pulmonary masses located adjacent to the chest wall, even when fluoroscopic or CT guidance was not effective. It is suitable for biopsying chest wall tumors, pleural lesions, and anterior mediastinal masses. It is particularly suited to biopsying small pulmonary nodules adjacent to the chest wall, nodules in the apical or juxtadiaphragmatic regions, and those obscured by pleural effusion.