Kuo T H, Hsu W H, Chiang C D, Huang C M, Chen C Y, Chang M C
Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan.
J Formos Med Assoc. 1998 Mar;97(3):197-203.
The purpose of this study was to assess the safety and reliability of ultrasound-guided fine needle aspiration biopsy (US-guided FNAB) combined with modified Papanicolaou's staining in the diagnosis of pulmonary cryptococcosis. The study included 10 patients (9 men, 1 woman, 28-70 yr). Percutaneous US-guided FNAB was performed through a puncture probe with central channel guidance (n = 8) or in a 'free-hand' manner (2), depending on the size of the lesion and the experience of the operator. Sonography disclosed homogeneously hypoechoic lesions with air bronchograms over the peripheral or central portion in nine patients, and occasional heterogeneous echogenicity with necrotic tissue without air bronchogram in one. Thirteen lesions were found on the chest radiographs of the 10 patients; these could be divided into three patterns: infiltrates (2), nodules or masses (7), and consolidation (4). Using US-guided FNAB and immediate modified Papanicolaou's stain, a diagnosis of pulmonary cryptococcosis was confirmed in nine of the 10 patients. The remaining case was proven by surgical resection. No major complications developed after US-guided FNAB. We conclude that this technique, combined with modified Papanicolaou's staining, provides a safe, rapid, and reliable method for diagnosing pulmonary cryptococcosis.
本研究的目的是评估超声引导下细针穿刺活检（US引导的FNAB）联合改良巴氏染色在肺隐球菌病诊断中的安全性和可靠性。该研究纳入了10例患者（9例男性，1例女性，年龄28 - 70岁）。根据病变大小和操作者经验，经皮US引导的FNAB通过带有中心通道引导的穿刺探头进行（n = 8）或以“徒手”方式进行（2例）。超声检查显示9例患者外周或中央部分有均匀低回声病变并伴有空气支气管征，1例偶尔有坏死组织的不均匀回声且无空气支气管征。10例患者的胸部X线片上发现13个病变；这些病变可分为三种类型：浸润型（2个）、结节或肿块型（7个）和实变型（4个）。通过US引导的FNAB及即时改良巴氏染色，10例患者中有9例确诊为肺隐球菌病。其余1例经手术切除证实。US引导的FNAB术后未发生重大并发症。我们得出结论，该技术联合改良巴氏染色为诊断肺隐球菌病提供了一种安全、快速且可靠的方法。
