Wang W D
Dept. Radiotherapy, Xingqiao Hospital, Third Military Medical University, PLA, Chongqing, Sichuan.
Zhonghua Zhong Liu Za Zhi. 1991 Sep;13(5):392-4.
The results of rapid percutaneous trough-needle biopsy of lung lesions in 68 cases (76 punctures) is reported. It was successful in 60 of the 68 cases (89.1%). After localizing the lesion on the simulator, TV screen of X-ray machine, or chest film, the procedure was performed with the X-ray switched off. Pneumothorax was observed in 8 cases (8/76 punctures, 10.5%) by routine chest film taken 1 1/2-2 hours after biopsy. 4 patients were asymptomatic (atelectasis below 20%). Pneumothorax could be induced if the needle was at an acute angle with the surface of the pleura at the time of puncture. The needle should pierce the pleura perpendicularly. Premature removal of the pith with the slot tip half-through the pleura might have been another cause of pneumothorax. As the movement of a coin lesion is wide during respiration, the patient must be trained to hold his breath at the end of inspiration or expiration and remains so during the puncture. The chance of success in puncturing a coin lesion could be increased if the lesion is so immobilized and visualized as it is pin-pointed with the rib out of the way at the time of puncture.