CT-guided cutting-needle biopsies of selected chest lesions

In an effort to improve on our diagnostic yield from percutaneous transthoracic biopsy, we used 14-gauge cutting needles in 56 selected patients. These biopsies were preceded by 18-, 20-, or 22-gauge aspirations in 42 patients, allowing a direct comparison of the efficacy of the needle types. Specific diagnoses were made by cutting-needle biopsy in 78% (25/32) of patients with nonlymphoproliferative malignancies, in 73% (8/11) with lymphoma or thymoma, and in 54% (7/13) of patients with benign diseases. In those in whom both aspiration and cutting needles were employed, a higher percentage of specific diagnoses was achieved by cutting-needle biopsy than by aspiration biopsy: 72% vs 64% in nonlymphoproliferative malignancies, 62% vs 12% in the lymphoproliferative group, and 55% vs 22% in benign disorders. Complications were encountered in 20% of all patients studied. This study shows that, for selected chest lesions, CT-guided cutting-needle biopsies can be performed safely and are useful, especially in the diagnosis of lymphoproliferative or benign disease.