Transthoracic Imaging-Guided Biopsy of Lung Lesions:
Evaluation of Benign Non-specific Pathologic Diagnoses
Nantaka Kiranantawat MD*,
Narapong Srisala MD*, Jitpreedee Sungsiri MD**,
Sarayut L Geater MD***, Wiwatana Tanomkiat MD*
Affiliation :
* Division of Diagnostic Imaging, Department of Radiology, Faculty of Medicine,
Prince of Songkla University, Hat Yai, Songkhla, Thailand
** Division of Interventional Radiology, Department of Radiology, Faculty of Medicine,
Prince of Songkla University, Hat Yai, Songkhla, Thailand
*** Division of Respiratory and Respiratory Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine,
Prince of Songkla University, Hat Yai, Songkhla, Thailand
Objective : Explore the definitive diagnoses of imaging-guided transthoracic needle biopsies (TNB) with a pathological
result of benign non-specific diagnosis in a tuberculosis-endemic area. The secondary goal was to characterize the initial
CT imaging findings between malignancy and benign lesions.
Material and Method: All TNB diagnoses considered to have benign non-specific features at the Radiology Department
between January 2007 and December 2011 were retrospectively reviewed for definitive diagnosis based on clinical impressions
and for CT imaging characteristics.
Results : Sixty-seven cases with TNB were given a benign non-specific diagnosis and had complete pathologic or radiologic
follow-ups. Of these 67 cases, 16 (23.9%) were malignant and 51 were benign. Two main definitive diagnoses of benign
cases were pulmonary tuberculosis (32.8%) and pneumonia/lung abscess (23.9%). On the CT images, most of lesions in
the group of pulmonary tuberculosis (14/22, 63.6%) were not enhanced after contrast administration (p<0.005), and necrotic
mediastinal lymph nodes were significantly found more in final malignancy diagnoses (p<0.005).
Conclusion : The definitive diagnoses of benign non-specific diagnoses based on TNB in this tuberculosis-endemic area had
a high rate of both malignancy and pulmonary tuberculosis. Hence, repeated biopsies or radiological follow-ups are advised.
Keywords : Benign non-specific diagnosis, Transthoracic needle biopsy (TNB), Pulmonary lesions
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