Significance of percutaneous needle biopsy in patients with multiple pulmonary nodules and a single known primary malignancy.

OBJECTIVE

To determine the necessity of percutaneous lung biopsy in patients with a single known primary malignancy and multiple pulmonary nodules.

DESIGN

Retrospective study.

SETTING

Tertiary care university hospital.

RESULTS

We reviewed all percutaneous lung biopsy specimens over a 6-year period. One hundred forty-six patients with a single known primary malignancy and multiple pulmonary nodules had biopsies performed up to 19 years following diagnosis of the primary neoplasm. One hundred thirty-seven biopsy specimens (93.8%) were positive for metastases. Eight patients (5.5%) had a nondiagnostic biopsy specimen; however, subsequent imaging studies and the clinical course strongly suggested diffuse metastatic disease. One patient (< 1%) with breast carcinoma developed nodules 3 years after initial diagnosis and had resolution without a definitive diagnosis or therapy.

CONCLUSION

Patients with a single known primary malignancy and multiple pulmonary nodules who present for percutaneous needle biopsy will have pulmonary metastases in the vast majority of cases. Biopsy in these patients rarely changes the clinical course as other diagnoses are rarely established.