The significance of percutaneous transthoracic needle biopsy in cases of small peripherally situated and mostly asymptomatic pulmonary lesions is evaluated. Three hundred and two patients out of 2,450 had such lung lesions, of whom 190 were cytologically classified as benign (64% inflammatory lesions or benign tumors), while 106 (36%) showed cytologic evidence of malignancy. The actual size of the lesions was between 4 mm and 2 cm in diameter. The lesions less than 1 cm in diameter sometimes required more than one attempt to obtain enough representative material, but no difficulties arose because of the localization, which for primary bronchial carcinomas showed a predilection for the upper lobes, while lung metastases of extrapulmonary tumors were found in all parts of the lungs. The number and type of complications did not differ significantly from that of other needle biopsies. There were eight false results in 302 patients (2.5%), of which four of 106 (4%) were false-positive findings and four of 196 (2%) were false-negative findings. In patients with small peripherally situated primary bronchial carcinomas, early diagnosis by transthoracic needle biopsy is feasible, which may improve the chances of a lower operative mortality, a better postoperative function of the remaining lung, and improved prospects of a final cure.
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W Sinner (1990) studied this question.