Abstract |
We searched the electronic patient database at The University of Texas M. D. Anderson Cancer Center for patients who underwent computed tomography (CT)-guided needle biopsy between January 2001 and December 2005. Inclusion criteria were a known history of haematologic malignancy and a newly detected, undiagnosed pulmonary lesion on chest CT that required tissue sampling for diagnosis; 213 met these criteria. We analysed the biopsy results for diagnostic yield, factors affecting diagnostic yield and effect on treatment. Of 213 procedures, 191 (89.7%) yielded sufficient material for pathologic analysis; 130 (60%) yielded specific diagnoses, while 61 (28.6%) yielded nonspecific benign diagnoses. Lesions larger than 1 cm, cavitary lesions and lung masses were more likely to yield a specific diagnosis than were lesions smaller than 1 cm, lung nodules and consolidations. The most common specific diagnoses were malignancy (62.8%) and infection (34.3%). The latter was more common in patients with leukaemia, cavitary lung lesions or consolidations, active underlying malignancy, neutropenia, respiratory signs and symptoms and/or fever, bone marrow transplant recipients, and in patients receiving chemotherapy. Lung lesions discovered upon follow-up imaging in patients who did not have any respiratory signs/symptoms or fever were mostly malignant. Therapeutic changes were more likely after a specific diagnosis than after a nonspecific diagnosis or a nondiagnostic biopsy (88.4% vs. 18.1%; p < 0.0001). CT-guided lung biopsy has a high diagnostic yield in patients with haematologic malignancies that present with unexplained pulmonary lesions and provides a specific diagnosis in a majority of these patients, leading to therapeutic changes.
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Authors | Sanjay Gupta, Mark Sultenfuss, Jorge E Romaguera, Joe Ensor, Savitri Krishnamurthy, Michael J Wallace, Kamran Ahrar, David C Madoff, Ravi Murthy, Marshall E Hicks |
Journal | Hematological oncology
(Hematol Oncol)
Vol. 28
Issue 2
Pg. 75-81
(Jun 2010)
ISSN: 1099-1069 [Electronic] England |
PMID | 19728397
(Publication Type: Journal Article)
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Copyright | (c) 2009 John Wiley & Sons, Ltd. |
Topics |
- Biopsy
(adverse effects, methods)
- Cryptogenic Organizing Pneumonia
(complications, diagnosis, pathology)
- Female
- Hematologic Neoplasms
(complications, pathology)
- Humans
- Immunocompromised Host
- Lung
(pathology)
- Lung Diseases
(complications, diagnosis, pathology)
- Lung Diseases, Fungal
(complications, diagnosis, pathology)
- Lung Neoplasms
(diagnosis, pathology, secondary)
- Male
- Myelodysplastic Syndromes
(complications, pathology)
- Neoplasms, Second Primary
(diagnosis, pathology)
- Pneumonia, Pneumocystis
(complications, diagnosis, pathology)
- Pneumothorax
(etiology)
- Radiography, Interventional
- Retrospective Studies
- Solitary Pulmonary Nodule
(diagnosis, pathology)
- Tomography, X-Ray Computed
- Tuberculosis, Pulmonary
(complications, diagnosis, pathology)
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