Sonographically guided needle biopsy in peripheral thoracic masses: results in 50 patients

50 patients with thoracic lesions were selected for percutaneous biopsy guided by real-time sonography. The indications were pulmonary, pleural and mediastinal lesions which made contact with the chest wall and sonographically accessible. Included were lesions near vital structures in the mediastinum (n = 3), in the apex of the lung (n = 8), small pulmonary nodules in contact with the chest wall (n = 24), lesions with intervening pleural fluid (n = 2), pleural nodules (n = 9) and masses arising from the chest wall itself (n = 4). A definitive diagnosis was established in 38 of the 45 (84.4%) malignant lesions and in 4 of the 5 (80%) benign lesions. Complications were restricted to one pneumothorax. Sonographically guided biopsy can be carried out as a bedside procedure. Real-time monitoring compensates for respiratory movements. Its role is curbed by intervening air such as in aerated lung, pneumothorax or primarily cavitatory lesions.