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Vol. 15. Issue 4.
Pages 589-595 (July - August 2009)
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Vol. 15. Issue 4.
Pages 589-595 (July - August 2009)
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Transthoracic biopsy with core cutting needle (Trucut) for the diagnosis of mediastinal tumors
Biópsia transtorácica com agulha cortante (Trucut) para o diagnóstico dos tumores mediastínicos
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Mauro Zamboni1,
Corresponding author
mauro.zamboni@gmail.com

Correspondence to/Correspondência: Rua Sorocaba 464/302 – CEP 22271-110 – Rio de Janeiro – RJ – Brasil.
, Deborah C. Lannes2, Paulo de Biasi Cordeiro3, Edson Toscano4, Emanuel B. Torquato4, Samuel S. de Biasi Cordeiro4, Aureliano Cavalcanti5
1 TE SBPT – Pneumologista do Grupo de Oncologia Torácica do HC I – INCA/MS/TE SBPT – Pulmonologist, Thoracic Oncology Group, HC I – INCA/MS
2 Pneumologista do Grupo de Oncologia Torácica do HC I – INCA/MS/Pulmonologist, Thoracic Oncology Group HC I – INCA/MS
3 TE SBCT – Cirurgião torácico – Director do HC I – INCA/MS/TE SBCT – Thoracic Surgeon, Head, HC I – INCA/MS
4 TE SBCT – Cirurgiões torácicos do HC I – INCA/MS/TE SBCT – Thoracic Surgeons, HC I – INCA/MS
5 TE SBCT – Cirurgião torácico – Chefe do Serviço de Cirurgia Torácica – HC I – INCA/MS/TE SBCT – Thoracic Surgeon, Head, Thoracic Surgery Unit, HC I – INCA/MS
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Abstract
Aim

To determine the contribution of percutaneous biopsy with core cutting needle (Trucut) in the diagnosis of mediastinal tumours.

Method

Retrospective review of 56 patients with mediastinal lesions who underwent percutaneous core cutting needle biopsy, oriented but not guided by computer assisted tomography of the thorax, 1999 – 2008.

Results

Percutaneous biopsy with core cutting needle provided adequate material in 49/56, with a total positive sample rate of 88%. In 7/56 (12%) cases the material was insufficient to define the diagnosis. Percutaneous core cutting needle biopsy established a specific histological diagnosis in 88% of the patients: 23/56 (41%) lymphomas; 12/56 (21%) thymomas; 5/56 (3%) thymic carcinomas; 3/56 (2%) small cell carcinoma and 1/56 (0.6%) metastatic adenocarcinoma, metastatic squamous cell carcinoma, neuroendocrine primitive carcinoma, plasmocytoma, teratoma and goiter. All patients underwent thoracic X-ray after the procedure. No complications were found in these patients.

Conclusion

Percutaneous core cutting needle biopsy (Trucut) oriented but not guided by computer assisted tomography of the thorax is an easy and safe procedure which can provide a precise diagnosis in the majority of mediastinal tumours and can prevent the need for exploratory thoracic surgery in cases which are medically treatable or non-resectable.

Key-words:
Biopsy
needle
Trucut needle biopsy
mediastinal/lesions
mediastinal neoplasms
Resumo
Objetivo

Determinar a contribuição da biópsia percutânea com agulha cortante (Trucut) no diagnóstico das massas mediastínicas.

Método

Revisão retrospectiva de 56 doentes com massas mediastínicas submetidos a biópsias com agulha cortante orientadas, mas não guiadas, pela tomografia computadorizada do tórax, no período de 1999 a 2008.

Resultados

A biópsia percutânea com agulha cortante forneceu material adequado para o diagnóstico em 49/56 casos, com índice de positividade de 88%. Em 7/56, o material colhido foi insuficiente para definir o diagnóstico (12%). Este método foi capaz de definir o diagnóstico em 88% dos doentes: 23/56 (41%) linfomas; 12/56 (21%) timomas; 5/56 (3%) carcinomas tímicos; 3/56 (2%) carcinoma indiferenciado de pequenas células e 1/56 (0,6%) adenocarcinoma metastático, carcinoma epidermóide metastático, carcinoma neuroendócrino primitivo, plasmocitoma, teratoma, bócio. Após a biópsia, os doen tes foram submetidos a radiografia do tórax. Não houve nenhum tipo de complicação nestes doentes.

Conclusão

A biópsia transtorácica com agulha cortante (Trucut) orientada, mas não guiada pela tomografia computadorizada, tem alto rendimento, esclrrecendo o diagnóstico na maioria dos portadores de massas mediastínicas e pode ser útil, evitando a toracotomia exploradora, nos casos de tumores do mediastino inoperáveis ou de tratamento quimioterápico.

Palavras-chave:
Biópsia por agulha
biópsia com agulha Trucut
neoplasias do mediastino
mediastino/lesões
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Trabalho realizado no Serviço de Cirurgia de Tórax do Hospital do Câncer I – INCA/MS – Rio de Janeiro/Work undertaken at the Serviço de Cirurgia de Tórax do Hospital do Câncer I – INCA/MS – Rio de Janeiro.

Copyright © 2009. Sociedade Portuguesa de Pneumologia
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