Role of fine-needle aspirates of focal lung lesions in patients with hematologic malignancies Journal Article
| Authors: | Wong, P. W.; Stefanec, T.; Brown, K.; White, D. A. |
| Article Title: | Role of fine-needle aspirates of focal lung lesions in patients with hematologic malignancies |
| Abstract: | Objectives: To evaluate the yield and safety of transthoracic fine-needle aspiration (FNA) in the diagnosis of pulmonary disease in patients with hematologic malignancy. Design: Retrospective chart review. Setting: Tertiary-care medical center. Patients: Sixty-seven patients with a hematologic malignancy or after bone marrow transplantation (BMT) for a hematologic malignancy who underwent a total of 71 FNAs for diagnosis of an unexplained parenchymal lung lesion from January 1, 1991, to June 30, 1999. Results: The underlying malignancy was lymphoma in 42 patients (63%), leukemia in 8 patients (12%), after allogeneic BMT in 12 patients (18%), after autologous BMT in 3 patients (4%), and other diseases in 2 patients. Radiographs showed focal abnormalities in all cases, and were nodules in 37%, masses in 37%, focal infiltrates in 21%, and cavitary lesions in 5%. The yield of FNA for a finding specific infection or cancer was 56% (40 of 71 FNAs). The FNA with inflammatory changes was clinically sufficient in another 11 patients for a total yield of 72% (51 of 71 FNAs). The yield for lung cancer was 90% (9 of 10 FNAs), for pulmonary lymphoma was 68% (21 of 31 FNAs), and for infection was 67% (10 of 15 FNAs). Complications occurred in 18 of 71 FNAs (25%), with pneumothorax in 14 patients (20%) and chest tube placement required in 4 patients (6%). Bleeding occurred in six patients (8%), including one death in a patient with abnormal hematologic parameters. Conclusion: Transthoracic FNA in patients with hematologic malignancy and focal lung lesions has an excellent yield for detecting cancer and a yield comparable to bronchoscopy for the diagnosis of infections. It should be considered a useful diagnostic tool in this setting. |
| Keywords: | adolescent; adult; controlled study; school child; leukemia; transplantation, homologous; human cell; major clinical study; clinical feature; cancer diagnosis; accuracy; infection; bleeding; lung neoplasms; differential diagnosis; inflammation; lung cancer; retrospective study; death; evaluation; pneumothorax; biopsy, needle; lymphoma; lung; radiography; bronchoscopy; safety; aspiration biopsy; bone marrow transplantation; lung infection; thorax drainage; lung infiltrate; hematologic disease; hematology; immunocompromised patient; lung diseases; lung injury; humans; human; male; female; priority journal; article; fine-needle lung aspirate; invasive radiology; transthoracic needle aspiration; lung cavity |
| Journal Title: | Chest |
| Volume: | 121 |
| Issue: | 2 |
| ISSN: | 0012-3692 |
| Publisher: | American College of Chest Physicians |
| Date Published: | 2002-02-01 |
| Start Page: | 527 |
| End Page: | 532 |
| Language: | English |
| DOI: | 10.1378/chest.121.2.527 |
| PUBMED: | 11834668 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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