Background: To study the diagnostic yield and complications of computed tomography (CT)-guided peripheral lung lesion biopsy.
Methods: We retrospectively studied the case records of 62 patients with undiagnosed peripheral lung lesions who underwent CT-guided lung biopsy, performed by a pulmonologist at our tertiary care institute during the period January 2015 to June 2017.
Results: Their mean age (range) was 56 (32-82) years; majority 38/62 (61%) were men. Thirty-nine (63%) patients were smokers. The overall yield was (60/62) 96.8%. The diagnosis was malignant in 46 (74.2%) and benign in 14 (22.6%) cases. Only two cases remain undiagnosed. The malignant lesions were small cell carcinoma–5, non-small cell lung carcinoma (NSCLC)–39, non- Hodgkin's lymphoma (NHL) and myofibroblastoma – one each. All NSCLC were in stage IIIB/C or IVA/B. The benign lesions were tuberculosis (TB) and post-TB lesions (n=6each) and anthracosis (n=2). Nine (14.5%) developed pneumothoraces and one required intercostal drainage. The pneumothorax was significantly more common with small size (<3cm) compared with large size lesion (>3cm) (p=0.039).
Conclusions: With the increasing use of mutational analysis and personalised therapy large biopsy is required. With limited availability of interventional radiologist in our country, the art of CT-guided biopsy should be learnt by the pulmonologist, since it is a cost-effective, reliable, first-line diagnostic procedure with comparable yield and complication in hands of pulmonologist.
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