Rodriguez Erika F, Pastorello Ricardo, Osmani Lais, Hopkins Mark, Kryatova Maria, Kawamoto Satomi, Maleki Zahra
Department of Pathology, Division of Cytopathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA,
Department of Pathology, Division of Cytopathology, A.C. Camargo Cancer Center, São Paulo, Brazil.
Acta Cytol. 2020;64(3):208-215. doi: 10.1159/000501421. Epub 2019 Jul 30.
Pulmonary adenocarcinoma is a major cause of mortality worldwide. The majority of patients present with advanced stage disease, and minimally invasive procedures are desirable for diagnosis and treatment plans. Herein, we report our experience with percutaneous/transthoracic needle aspiration (TT-NA) in the cytologic diagnosis of pulmonary adenocarcinoma.
After institutional review board approval, the cytopathology electronic data system was searched for all consecutive TT-NA of the lung masses from January 2011 to November 2015. Patients' medical records were reviewed and cytologic materials were evaluated.
A total of 151 specimens were identified, with a mean age of 62.8 years; 62.9% of the patients had a prior history of malignancy. Carcinoma/adenocarcinoma was the most common (80%) diagnosis. The targeted lesions were predominantly located in the lung (56.3%, 81/151) and pleural based (27.8%, 42/151). The mean size of the lesions was 3.6 cm. Cytology specimens were adequate in 70.9% of the cases, while 72.8% (110/151) of the cases also had concurrent core biopsy. A malignant diagnosis was rendered in the majority of the cases (64.9%). In 71% of the cases, immunohistochemistry/histochemistry studies were successfully performed. Molecular/genetic studies were requested in 80% of the cases and had adequate material. Complications of the procedure were seen in 9.9% of the patients including pneumothorax (7.9%) and hemoptysis (1.9%).
TT-NA is a relatively safe and reliable technique in the assessment of pulmonary lesions.
肺腺癌是全球主要的死亡原因。大多数患者就诊时已处于疾病晚期，因此诊断和治疗方案中希望采用微创方法。在此，我们报告经皮/经胸针吸活检（TT-NA）在肺腺癌细胞学诊断中的经验。
经机构审查委员会批准后，检索细胞病理学电子数据系统，查找2011年1月至2015年11月期间所有连续的肺肿块TT-NA病例。查阅患者病历并评估细胞学材料。
共鉴定出151份标本，患者平均年龄为62.8岁；62.9%的患者有恶性肿瘤病史。癌/腺癌是最常见的诊断（80%）。靶向病变主要位于肺部（56.3%，81/151）和胸膜（27.8%，42/151）。病变的平均大小为3.6厘米。70.9%的病例细胞学标本足够，同时72.8%（110/151）的病例还进行了同步芯针活检。大多数病例（64.9%）做出了恶性诊断。71%的病例成功进行了免疫组织化学/组织化学研究。80%的病例要求进行分子/基因研究且材料充足。9.9%的患者出现了该操作的并发症，包括气胸（7.9%）和咯血（1.9%）。
TT-NA是评估肺部病变的一种相对安全可靠的技术。
