Percutaneous lung needle biopsies – utility and complications in various chest lesions: a single-institution experience

PURPOSE: It is crucial to obtain a specific diagnosis before treatment of chest pathology is initiated. The purpose of the study is to present the utility of percutaneous biopsies, core and fine-needle aspiration, in various thoracic lesions, and related complications. MATERIAL AND METHODS: A total of 593 transthoracic biopsies were performed in the Department of Radiology between 2013 and 2016. Fine-needle aspiration biopsy (FNAB) and core biopsy (CB) were implemented. The procedures were divided into four groups according to the location of the pathology: lung lesions (LL – 540), mediastinal masses (MM – 25), chest wall tumours (CWT – 13), and pleural lesions (PL – 15). The lung lesion group was divided into two subgroups: lung nodules and lung infiltrations. All groups were analysed in respect of diagnostic accuracy, pathological findings, and complication rate. RESULTS: Pathological diagnosis was confirmed in 447 cases after all 593 procedures. The sensitivity of malignancy diagnosis in the group of lung tumours was 75% for FNAB and 89% for CB. The sensitivity in other groups, where CB was a preferable technique, was counted for lung infiltration, mediastinal masses, chest wall tumours, and pleural lesions and amounted to 83.3%, 90.9%, 100%, and 85.7%, respectively. In the group of lung tumours malignancy was confirmed most commonly (79%), while in the lung infiltration group benign processes dominated (83%). There was no statistical difference between the pneumothorax rate after CB and FNAB. Haemoptysis appeared more often after CB. CONCLUSIONS: FNAB and CB are useful, safe, and sensitive tools in the diagnostic work-up. They can both be used to diagnose almost all chest pathologies.