Article Sidebar
Views pdf: 45
PATHOLOGICAL RESULTS FROM CT-GUIDED TRANSTHORACIC LUNG BIOPSY AT GIA DINH PEOPLE’S HOSPITAL
Main Article Content
Abstract
Objective: To determine the diagnostic value of computed tomography (CT) - guided trans-thoracic lung biopsy through the rate of conclusive histopathological results and histological distribution, and to assess the association between histopathology and procedural safety. Materials and Methods: This was a cross-sectional study with convenience sampling, including 331 patients with suspected malignant pulmonary lesions who underwent CT-guided transthora-cic lung biopsy at Gia Dinh People’s Hospital from 01/2022 to 12/2023. Inclusion/exclusion and technical criteria were standardized. All procedures were performed by certified interventional radiologists with ≥10 years of experience. Histopathological slides were reviewed by board-certified pathologists using a Nikon E200 microscope. Main Results: Histopathological evaluation revealed malignant cells in 235/331 (71%) cases, while 96/331 (29%) showed no evidence of malignancy. Adenocarcinoma was the most common subtype, accounting for 165/331 (49.8%), followed by small cell carcinoma (1.8%). Pneumothorax occurred in 30.5% of patients, with 9.9% of these cases requiring intervention (needle aspiration in 3, chest tube drainage in 7). Pulmonary hemorrhage occurred in 14.5%, with only one case requiring endovascular intervention due to hemoptysis. There was no significant association between histopathological diagnosis and complication rates (pneumothorax or pulmonary hemorrhage). Conclusion: CT-guided transthoracic lung biopsy achieved a high diagnostic yield, with a malignancy detection rate of 71% and successful histological subtyping, thereby contributing to definitive diagnosis and treatment planning. The procedure demonstrated an acceptable safety profile in experienced centers, with pneumothorax being the main complication but requiring intervention in only a minority of cases. The findings support CT-guided transthoracic lung biopsy as a valuable diagnostic tool in clinical practice, though protocol optimization is warranted to further minimize complications.
Article Details
Keywords
transthoracic biopsy, CT, lung tumor, histopathology, diagnostic value
References
2. Ettinger D. J. N. C. C. N. (2020), "NCCN clinical guidelines in oncology: non‐small cell lung cancer", 3, pp. 1.
3. Heerink W. J., de Bock G. H., de Jonge G. J., et al. (2017), "Complication rates of CT-guided transthoracic lung biopsy: meta-analysis", 27 (1), pp. 138-148.
4. Kim J., Chee C. G., Cho J., et al. (2021), "Diagnostic accuracy and complication rate of image-guided percutaneous transthoracic needle lung biopsy for subsolid pulmonary nodules: a systematic review and meta-analysis", 94 (1127), pp. 20210065.
5. Laurent F., Latrabe V., Vergier B., et al. (2000), "CT-guided transthoracic needle biopsy of pulmonary nodules smaller than 20 mm: results with an automated 20-gauge coaxial cutting needle", 55 (4), pp. 281-287.
6. Lindeman N. I., Cagle P. T., Aisner D. L., et al. (2018), "Updated molecular testing guideline for the selection of lung cancer patients for treatment with targeted tyrosine kinase inhibitors: guideline from the College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology", 142 (3), pp. 321-346.
7. Liu G.-S., Wang S.-Q., Liu H.-L., et al. (2020), "Computed tomography-guided biopsy for small (≤ 20 mm) lung nodules: a meta-analysis", 44 (6), pp. 841-846.
8. Sung H., Ferlay J., Siegel R. L., et al. (2021), "Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries", 71 (3), pp. 209-249.
9. Youlden D. R., Cramb S. M., Baade P. D. J. J. o. t. o. (2008), "The International Epidemiology of Lung Cancer: geographical distribution and secular trends", 3 (8), pp. 819-831.