CT-guided transthoracic fine-needle aspiration versus transbronchial fluoroscopy-guided needle aspiration in pulmonary nodules.

PURPOSE

To evaluate the diagnostic yield of CT-guided (CTNAB) and fluoroscopy-guided transbronchial (TBNA) fine-needle aspiration cytology in pulmonary nodules and to compare their complications.

MATERIAL AND METHODS

Thirty patients with pulmonary nodules not abutting upon the chest wall and inaccessible to bronchoscopy were randomised for CTNAB or TBNA. Eighteen patients underwent CTNAB and 16 TBNA. Four patients underwent both procedures.

RESULTS

In the CTNAB group, a definitive diagnosis could be made in 14 (78%) out of 18 patients whereas in the TBNA group, a definitive diagnosis was made in 11 (69%) out of 16 patients. This difference was not statistically significant (p > 0.05). The final diagnosis in 29 out of 30 patients comprised primary bronchogenic carcinoma in 14 patients, metastases in 5 patients, and benign lesions in 10 patients (34%) of which 3 lesions (30%) were of tuberculous aetiology. There were 2 asymptomatic pneumothoraces in the CTNAB group and no complication was observed in the TBNA group.

CONCLUSION

Both techniques were safe and effective in the diagnosis of peripheral pulmonary lesions. TBNA was best suited for lesions larger than 3 cm and located in the middle and lower lobes while CTNAB could be used for any lesions.