CT-guided percutaneous transthoracic biopsy in the evaluation of undetermined pulmonary lesions
Biópsia percutânea transtorácica guiada por TC na avaliação de lesões pulmonares de natureza indeterminada
Rute Lourenço1,
, Rui Camacho1, Maria João Barata1, Dolores Canário2, Augusto Gaspar3, Carlos Cyrne4
Corresponding author
rutelourenco@netcabo.pt
Correspondence to/Correspondência: Serviço de Radiologia, Hospital Garcia de Orta, SA, Almada, Tel.: +212727253.
Correspondence to/Correspondência: Serviço de Radiologia, Hospital Garcia de Orta, SA, Almada, Tel.: +212727253.
1 Interno/a de Radiologia, Serviço de Radiologia (Director: Dr. Carlos Cyrne), Radiology intern, Radiology Unit, Hospital Garcia de Orta, SA, Almada, Portugal
2 Assistente Graduada de Pneumologia, Serviço de Pneumologia (Director: Dr. Jorge Roldão Vieira), Graduate Pulmonology Assistant, Pulmonology Unit, Hospital Garcia de Orta, SA, Almada, Portugal
3 Assistente Graduado de Radiologia, Serviço de Radiologia (Director: Dr. Carlos Cyrne), Graduate Radiology Assistant, Radiology Unit, Hospital Garcia de Orta, SA, Almada, Portugal
4 Director do Serviço de Radiologia do HGO, Director, Radiology Unit, HGO, Hospital Garcia de Orta, SA, Almada, Portugal
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array:1 [ 0 => array:2 [ "paginaInicial" => "503" "paginaFinal" => "524" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Rute Lourenço, Rui Camacho, Maria João Barata, Dolores Canário, Augusto Gaspar, Carlos Cyrne" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Rute" "apellidos" => "Lourenço" "email" => array:1 [ 0 => "rutelourenco@netcabo.pt" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Rui" "apellidos" => "Camacho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Maria" "apellidos" => "João Barata" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ 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Pulmonology Assistant, Pulmonology Unit, Hospital Garcia de Orta, SA, Almada, Portugal" "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Assistente Graduado de Radiologia, Serviço de Radiologia (Director: Dr. Carlos Cyrne), Graduate Radiology Assistant, Radiology Unit, Hospital Garcia de Orta, SA, Almada, Portugal" "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Director do Serviço de Radiologia do HGO, Director, Radiology Unit, HGO, Hospital Garcia de Orta, SA, Almada, Portugal" "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondence to/Correspondência: Serviço de Radiologia, Hospital Garcia de Orta, SA, Almada, Tel.: +212727253." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Biópsia percutânea transtorácica guiada por TC na avaliação de lesões pulmonares de natureza indeterminada" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-05-09" "fechaAceptado" => "2006-06-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec158831" "palabras" => array:3 [ 0 => "Percutaneous transthoracic biopsy" 1 => "computed tomography" 2 => "undetermined pulmonary lesions" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras chave" "identificador" => "xpalclavsec158830" "palabras" => array:3 [ 0 => "Biópsia percutânea transtorácica" 1 => "tomografia computorizada" 2 => "lesões pulmonares indeterminadas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">CT-guided Percutaneous Transthoracic Biopsies (PTB) performed in the Radiology Department of Garcia de Orta Hospital between 2002 and 2004 to evaluate undetermined pulmonary lesions were retrospectively analysed. 89 fine needle aspiration biopsies (FNAB) and 13 core needle biopsies (CNB) were performed on 92 patients (67 men, mean age: 64.4 years). 82 lesions (89%) were nodular lesions (mean diameter: 3.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.7<span class="elsevierStyleHsp" style=""></span>cm, 65 peripheral). We did not observe complications among patients who underwent CNB; minor complications and pneumothorax requiring drainage occurred in 11 FNAB. 72 FNAB were considered adequate for cytology diagnosis; 72% of them positive for malignancy. All CNB were adequate and conclusive. From the 7 CNB performed on patients with previous FNAB, 3 allowed a better histological characterization and in 3 cases of inadequate FNAB, CNB was conclusive. All malignant lesions were nodules: 20 adenocarcinoma, 13 non-small cell lung cancer (SCLC), 10 epidermoid tumours, 5 small-cell lung cancer, 2 carcinoids, 1 bronchiolo alveolar carcinoma, 1 malignant mesothelioma and 8 metastasis. Unspecific/ inflammatory lesions (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>5) were the most frequent benign lesions. Malignant lesions were more prevalent in older patients (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.007) and were larger (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.006). Spiculated and lobulated contour (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05) were more prevalent in malignant lesions while regular contour was more frequent among benign lesions (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0001). Gender, smoking, location, pleural tag, homogenous attenuation, cavitation, calcification, necrosis and air bronchogram did not differ significantly between benign and malignant nodules.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This study shows that CT-guided PTB is a safe and effective procedure in the evaluation of undetermined pulmonary lesions.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Avaliação retrospectiva das biópsias percutâneas transtorácicas (BPTT) guiadas por TC de lesões pulmonares indeterminadas, realizadas no Serviço de Radiologia do Hospital Garcia de Orta entre 2002 e 2004. Realizaram-se 89 biópsias aspirativas (BA) e 13 biópsias <span class="elsevierStyleItalic">core</span> (BC) a 92 doentes (67 homens, idade média 64,4 anos). Oitenta e duas lesões (89%) corresponderam a lesões nodulares (diâmetro médio: 3,8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,7<span class="elsevierStyleHsp" style=""></span>cm, 65 periféricas). Não obtivemos complicações nas BC. Ocorreram complicações <span class="elsevierStyleItalic">minor</span> em 11 BA e um caso de pneumotórax com necessidade de drenagem. Setenta e duas BA foram adequadas para diagnóstico citológico, positivo para células neoplásicas em 72% dos casos. Em todas as BC a amostra foi adequada e conclusiva. Das 7 BC realizadas a doentes com BA, 3 permitiram uma melhor caracterização histológica e, em 3, a BC permitiu o diagnóstico histológico. Todos os diagnósticos malignos corresponderam a lesões nodulares: adenocarcinoma (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20), carcinoma de não pequenas células pouco diferenciado (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13), epidermóide (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>10), de pequenas células (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>5), tumor carcinóide (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2), carcinoma bronquíolo-alveolar (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1), mesotelioma maligno (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1) e metástases (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8). As alterações inflamatórias/inespecíficas (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>5) foram as lesões benignas mais frequentes. A idade (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,007) e o diâmetro da lesão (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,006) foram superiores nos nódulos malignos. Os contornos espiculados e lobulados (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,05) foram mais prevalentes nas lesões malignas e os contornos regulares nas benignas (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,0001). Não se verificou diferença estatisticamente significativa relativamente ao sexo, tabagismo, localização, cauda pleural, atenuação homogénea, cavitação, calcificações, necrose e broncograma aéreo.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Concluiu-se que a BPTT guiada por TC é uma técnica segura e eficaz na avaliação de lesões pulmonares indeterminadas.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography/Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: comparison of small and large pulmonary nodules" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "H. Li" 1 => "P.M. Boiselle" 2 => "J.O. 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| Year/Month | Html | Total | |
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| 2024 November | 5 | 6 | 11 |
| 2024 October | 28 | 30 | 58 |
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| 2024 January | 15 | 21 | 36 |
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