Computed tomography- guided percutaneous core needle biopsy for diagnosis of intathoracic mass lesions: experience at a tertiary care centre of North India

Authors

  • Shivanjali Raghuvanshi Department of Pathology, King George’s Medical College, Lucknow, Uttar Pradesh, India
  • Shalini Bhalla Department of Pathology, King George’s Medical College, Lucknow, Uttar Pradesh, India
  • Vanshika Shahi Department of Pathology, King George’s Medical College, Lucknow, Uttar Pradesh, India
  • Manoj Kumar Department of Radiodiagnosis, King George’s Medical College, Lucknow, Uttar Pradesh, India
  • Sumaira Qayoom Department of Pathology, King George’s Medical College, Lucknow, Uttar Pradesh, India
  • Shalini Rawat Department of Pathology, King George’s Medical College, Lucknow, Uttar Pradesh, India
  • Anand Srivastava Department of Respiratory Medicine, King George’s Medical College, Lucknow, Uttar Pradesh, India
  • Madhu Mati Goel Department of Pathology, King George’s Medical College, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20190914

Keywords:

CT guided biopsy, Intrathoracic mass lesions, Lung, Mediastinal, PCNB

Abstract

Background: CT guided core needle biopsy is a less invasive method for initial diagnostic workup in the assessment of intrathoracic masses. This study was conducted to evaluate the diagnostic yield of the procedure as well as to demonstrate the spectrum of various disease in our population.

Methods: Present study was conducted in a tertiary care hospital for a study period of two years. Patients with intrathoracic mass were included and CT guided biopsies were performed following a protocol. The CT guided biopsies received were examined for histological diagnosis. Immunohistochemistry was carried out where ever routine histopathology was not sufficient for diagnosis. Relevant immunohistochemical panels were applied for lung, mediastinal and pleural tumours according to the histological differential diagnosis. Detailed demographic and clinical profiles along with radiological findings were noted.

Results: Total of 138 cases were taken for CT guided FNAC procedure and 123 (89.1%) cases yielded diagnostic biopsy. Lung was the most commonly involved organ followed by mediastinum. Bronchogenic carcinoma was the most common lesion reported in lung and Non-Hodgkin Lymphoma was the most common mediastinal lesion. Lung collapse was most common radiological feature.

Conclusions: CT guided percutaneous biopsy is a valuable diagnostic technique providing for early accurate diagnosis and being minimally invasive procedure. Care should be taken while tissue processing and section cutting of intrathoracic biopsies as the biopsies are small and tissue loss should be prevented so that sufficient material is available for immunohistochemistry.

References

de Farias AP, Deheinzelin D, Younes RN, Chojnaik R. Computed tomography-guided biopsy of mediastinal lesions: fine versus cutting needles. Rev Hosp Clin Fac Med Sao Paulo. 2003;58(2):69-74.

Rabbani M, Sarrami AH. Computed tomography-guided percutaneous core needle biopsy for diagnosis of mediastinal mass lesions: Experience with 110 cases in two university hospitals in Isfahan, Iran. Adv Biomed Res. 2016;5.

de Margerie-Mellon C, de Bazelaire C, Amorim S, Brice P, Tazi A, Brière J, et al. Diagnostic Yield and Safety of Computed Tomography–guided Mediastinal Core Needle Biopsies. J Thoracic Imaging. 2015 Sep 1;30(5):319-27.

Kulkarni S, Kulkarni A, Roy D, Thakur MH. Percutaneous computed tomography-guided core biopsy for the diagnosis of mediastinal masses. Ann Thorac Med. 2008 Jan;3(1):13-7.

Capalbo E, Peli M, Lovisatti M, Cosentino M, Mariani P, Berti E, et al. Trans-thoracic biopsy of lung lesions: FNAB or CNB? Our experience and review of the literature. Radiol Med. 2014 Aug;119(8):572-94.

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010 Dec 15;127(12):2893-917.

Ocak S, Duplaquet F, Jamart J, Pirard L, Weynand B, Delos M, et al. Diagnostic Accuracy and Safety of CT-Guided Percutaneous Transthoracic Needle Biopsies: 14-Gauge versus 22-Gauge Needles. J Vasc Interv Radiol. 2016 May;27(5):674-81.

de Kerviler E, Benet C, Brière J, de Bazelaire C. Image-guided needle biopsy for diagnosis and molecular biology in lymphomas. Best Pract Res Clin Haematol. 2012 Mar;25(1):29-39.

Zafar N, Moinuddin S. Mediastinal needle biopsy. A 15-year experience with 139 cases. Cancer. 1995;76:1065-8.

Greif J, Staroselsky AN, Gernjac M, Schwarz Y, Marmur S, Perlsman M, et al. Percutaneous core needle biopsy in the diagnosis of mediastinal tumors. Lung Cancer. 1999;25:169-73.

Guleria JS, Gopinath N, Talwar JR, Bhargave S, Pande JN, Gupta RG. Bronchial carcinoma - an analysis of 120 cases. J Assoc Physicians India 1971;19:251-5.

Jindal SK, Behera D. Clinical spectrum of primary lung cancer-review of Chandigarh experience of 10 years. Lung India. 1990 May 1;8(2):94-8.

Gupta RC, Purohit SD, Sharma MP, Bhardwaj S. Primary bronchogenic carcinoma: clinical profile of 279 cases from mid-west Rajasthan. Indian J Chest Dis Allied Sci. 1998;40(2):109-16.

Prasad R, James P, Kesarwani V, Gupta R, Pant MC, Chaturvedi A, Shrivastava AN. Clinicopathological study of bronchogenic carcinoma. Respirol. 2004 Nov;9(4):557-60.

Meza R, Meernik C, Jeon J, Cote ML. Lung cancer incidence trends by gender, race and histology in the United States, 1973-2010. PLoS One. 2015;10(3):e0121323.

Krishnamurthy A, Vijayalakshmi R, Gadigi V, Ranganathan R, Sagar TG. The relevance of" Nonsmoking-associated lung cancer" in India: A single-centre experience. Indian J Cancer. 2012 Jan 1;49(1):82-8.

Noronha V, Dikshit R, Raut N, Joshi A, Pramesh CS, George K, et al. Epidemiology of lung cancer in India: focus on the differences between non-smokers and smokers: a single-centre experience. Indian J Cancer. 2012;49:74-81.

Takahashi K, Al-Janabi NJ. Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging. 2010;32:1325-39.

Zinzani PL, Corneli G, Cancellieri A, Magagnoli M, Lacava N, Gherlinzoni F, et al. Core needle biopsy is effective in the initial diagnosis of mediastinal lymphoma. Haematologica. 1999 Jan 1;84(7):600-3.

Demharter J, Müller P, Wagner T, Schlimok G, Haude K, Bohndorf K. Percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and subclassification of malignant lymphomas. Eur Radiol. 2001 Jan 1;11(2):276-83.

Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol. 2017 Jan 1;27(1):138-48.

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Published

2019-02-27

How to Cite

Raghuvanshi, S., Bhalla, S., Shahi, V., Kumar, M., Qayoom, S., Rawat, S., Srivastava, A., & Goel, M. M. (2019). Computed tomography- guided percutaneous core needle biopsy for diagnosis of intathoracic mass lesions: experience at a tertiary care centre of North India. International Journal of Research in Medical Sciences, 7(3), 663–668. https://doi.org/10.18203/2320-6012.ijrms20190914

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Original Research Articles