Aspiration of thoracic masses and fluid collections under guidance of ultrasonography.

Successful ultrasonic detection and fine needle aspiration of pleural effusions, loculated fluid, and peripheral lung masses were done in 115 patients. No complications, eg, pneumothorax or hematoma, were caused by the fine needle aspirations. There was no false-negative or false-positive cytology because of excellent localization by ultrasound and adequate tissue samples. This series shows ultrasonography to be a valid method of evaluating chest lesions seen to be peripheral on chest roentgenograms. The cystic or solid nature of these lesions was determined; however, we experienced difficulty in differentiating small amounts of loculated fluid from pleural thickening in a few cases. Difficulties were also noted with a few small peripheral tumors that appeared to be cystic on ultrasonography but were proven to be solid by fine needle aspiration. These problems can be resolved by an experienced sonographer using equipment with higher resolution, but we did not hesitate to do fine needle aspiration in such circumstances.