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Ann Thorac Surg 1991;51:390-393
© 1991 The Society of Thoracic Surgeons

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Articles

Role of percutaneous fine-needle aspiration biopsy in suspected intrathoracic malignancy

^a Division of Surgical Oncology, Jonnson Comprehensive Cancer Center, University of California, Los Angeles, California USA
^b Department of Pathology, Cytology Service, Center for the Health Sciences, University of California, Los Angeles, California USA

Accepted for publication October 22, 1990.

^_* Address reprint requests to Dr Morton, Division of Surgical Oncology, Jonnson Comprehensive Cancer Center, Louis Factor Building, Room 9-260, Los Angeles, CA 90024.

Percutaneous fine-needle aspiration (PFNA) biopsy is an accepted technique for the diagnosis of suspected intra-thoracic malignancy, but the appropriate indications for its use have not been clearly defined. To help establish guidelines, we performed a retrospective analysis of 188 patients who underwent PFNA biopsy for suspected intrathoracic malignancy. Biopsy led to a diagnosis in 72% ([equation]) of the patients, but in 27% ([equation]) samples were inadequate for cytological diagnosis, and in 2% ([equation]) samples were adequate but failed to yield a diagnosis. Fifty-three patients underwent surgical intervention, thus allowing histological confirmation of the cytological diagnosis. In patients with a diagnosis from PFNA biopsy, operation confirmed malignancy in 97% ([equation]) and a specific cell type in 79% ([equation]). In patients without a diagnosis after biopsy, a malignancy was found in 73% ([equation]) at the time of operation. This suggests a high rate of accuracy when PFNA biopsy provides a diagnosis. However, it also illustrates that a substantial percentage of PFNA biopsy attempts fail to yield a diagnosis in patients ultimately found to have malignancies. This implies that PFNA biopsy might best be reserved for patients who are not surgical candidates.

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