Percutaneous computed tomography-guided lung biopsy and pleural dissemination: An assessment by intraoperative pleural lavage cytology

Yoshifumi Sano, Hiroshi Date, Shinichi Toyooka, Takahiro Oto, Masaomi Yamane, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Susumu Kanazawa

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14 Citations (Scopus)

Abstract

BACKGROUND: Percutaneous computed tomography (CT)-guided needle biopsy remains one of the most important diagnostic tools in the management of lung nodules; however, it carries a risk of intrapleural dissemination of cancer cells. METHODS: CT-guided lung biopsy was performed before surgery in 171 (34.8%) of 491 patients. A coaxial biopsy system was used that comprised a 19-gauge introducer needle and a 20-gauge core biopsy needle. A total of 412 (83.9%) of the 491 patients underwent intraoperative pleural lavage cytology just after thoracotomy. Intraoperative pleural lavage cytology was performed immediately after opening the thorax, after the pleural cavity was gently washed with 50 mL of saline. RESULTS: No patients had implantation of cancer cells in the chest wall after a median follow-up of 20.2 months. Intraoperative pleural lavage cytology results were positive for 5 (2.9%) of the 171 patients who underwent CT-guided biopsy before surgery, in contrast to 13 (5.4%) of the 241 patients who did not undergo biopsy before surgery. The difference between the biopsy and nonbiopsy groups was not statistically significant. When the analysis was limited to patients with stage IA disease, intraoperative pleural lavage cytology results were positive for 1 (0.8%) of the 128 patients who underwent CT-guided biopsy, in contrast to 3 (2.7%) of the 110 patients who did not undergo biopsy. This difference was also not statistically significant. CONCLUSIONS: No significant association was observed between percutaneous CT-guided lung biopsy and intraoperative pleural lavage cytology results, even in patients with stage IA disease. Percutaneous CT-guided lung biopsy with a coaxial needle does not seem to cause pleural dissemination.

Original languageEnglish
Pages (from-to)5526-5533
Number of pages8
JournalCancer
Volume115
Issue number23
DOIs
Publication statusPublished - Jan 12 2009

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Therapeutic Irrigation
Cell Biology
Tomography
Biopsy
Lung
Needles
Pleural Diseases
Large-Core Needle Biopsy
Pleural Cavity
Needle Biopsy
Thoracic Wall
Thoracotomy
Neoplasms
Thorax

Keywords

  • Cytology
  • Lavage
  • Lung cancer
  • Malignant pleural effusion
  • Needle biopsy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

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title = "Percutaneous computed tomography-guided lung biopsy and pleural dissemination: An assessment by intraoperative pleural lavage cytology",
abstract = "BACKGROUND: Percutaneous computed tomography (CT)-guided needle biopsy remains one of the most important diagnostic tools in the management of lung nodules; however, it carries a risk of intrapleural dissemination of cancer cells. METHODS: CT-guided lung biopsy was performed before surgery in 171 (34.8{\%}) of 491 patients. A coaxial biopsy system was used that comprised a 19-gauge introducer needle and a 20-gauge core biopsy needle. A total of 412 (83.9{\%}) of the 491 patients underwent intraoperative pleural lavage cytology just after thoracotomy. Intraoperative pleural lavage cytology was performed immediately after opening the thorax, after the pleural cavity was gently washed with 50 mL of saline. RESULTS: No patients had implantation of cancer cells in the chest wall after a median follow-up of 20.2 months. Intraoperative pleural lavage cytology results were positive for 5 (2.9{\%}) of the 171 patients who underwent CT-guided biopsy before surgery, in contrast to 13 (5.4{\%}) of the 241 patients who did not undergo biopsy before surgery. The difference between the biopsy and nonbiopsy groups was not statistically significant. When the analysis was limited to patients with stage IA disease, intraoperative pleural lavage cytology results were positive for 1 (0.8{\%}) of the 128 patients who underwent CT-guided biopsy, in contrast to 3 (2.7{\%}) of the 110 patients who did not undergo biopsy. This difference was also not statistically significant. CONCLUSIONS: No significant association was observed between percutaneous CT-guided lung biopsy and intraoperative pleural lavage cytology results, even in patients with stage IA disease. Percutaneous CT-guided lung biopsy with a coaxial needle does not seem to cause pleural dissemination.",
keywords = "Cytology, Lavage, Lung cancer, Malignant pleural effusion, Needle biopsy",
author = "Yoshifumi Sano and Hiroshi Date and Shinichi Toyooka and Takahiro Oto and Masaomi Yamane and Takao Hiraki and Hideo Gobara and Hidefumi Mimura and Susumu Kanazawa",
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TY - JOUR

T1 - Percutaneous computed tomography-guided lung biopsy and pleural dissemination

T2 - An assessment by intraoperative pleural lavage cytology

AU - Sano, Yoshifumi

AU - Date, Hiroshi

AU - Toyooka, Shinichi

AU - Oto, Takahiro

AU - Yamane, Masaomi

AU - Hiraki, Takao

AU - Gobara, Hideo

AU - Mimura, Hidefumi

AU - Kanazawa, Susumu

PY - 2009/1/12

Y1 - 2009/1/12

N2 - BACKGROUND: Percutaneous computed tomography (CT)-guided needle biopsy remains one of the most important diagnostic tools in the management of lung nodules; however, it carries a risk of intrapleural dissemination of cancer cells. METHODS: CT-guided lung biopsy was performed before surgery in 171 (34.8%) of 491 patients. A coaxial biopsy system was used that comprised a 19-gauge introducer needle and a 20-gauge core biopsy needle. A total of 412 (83.9%) of the 491 patients underwent intraoperative pleural lavage cytology just after thoracotomy. Intraoperative pleural lavage cytology was performed immediately after opening the thorax, after the pleural cavity was gently washed with 50 mL of saline. RESULTS: No patients had implantation of cancer cells in the chest wall after a median follow-up of 20.2 months. Intraoperative pleural lavage cytology results were positive for 5 (2.9%) of the 171 patients who underwent CT-guided biopsy before surgery, in contrast to 13 (5.4%) of the 241 patients who did not undergo biopsy before surgery. The difference between the biopsy and nonbiopsy groups was not statistically significant. When the analysis was limited to patients with stage IA disease, intraoperative pleural lavage cytology results were positive for 1 (0.8%) of the 128 patients who underwent CT-guided biopsy, in contrast to 3 (2.7%) of the 110 patients who did not undergo biopsy. This difference was also not statistically significant. CONCLUSIONS: No significant association was observed between percutaneous CT-guided lung biopsy and intraoperative pleural lavage cytology results, even in patients with stage IA disease. Percutaneous CT-guided lung biopsy with a coaxial needle does not seem to cause pleural dissemination.

AB - BACKGROUND: Percutaneous computed tomography (CT)-guided needle biopsy remains one of the most important diagnostic tools in the management of lung nodules; however, it carries a risk of intrapleural dissemination of cancer cells. METHODS: CT-guided lung biopsy was performed before surgery in 171 (34.8%) of 491 patients. A coaxial biopsy system was used that comprised a 19-gauge introducer needle and a 20-gauge core biopsy needle. A total of 412 (83.9%) of the 491 patients underwent intraoperative pleural lavage cytology just after thoracotomy. Intraoperative pleural lavage cytology was performed immediately after opening the thorax, after the pleural cavity was gently washed with 50 mL of saline. RESULTS: No patients had implantation of cancer cells in the chest wall after a median follow-up of 20.2 months. Intraoperative pleural lavage cytology results were positive for 5 (2.9%) of the 171 patients who underwent CT-guided biopsy before surgery, in contrast to 13 (5.4%) of the 241 patients who did not undergo biopsy before surgery. The difference between the biopsy and nonbiopsy groups was not statistically significant. When the analysis was limited to patients with stage IA disease, intraoperative pleural lavage cytology results were positive for 1 (0.8%) of the 128 patients who underwent CT-guided biopsy, in contrast to 3 (2.7%) of the 110 patients who did not undergo biopsy. This difference was also not statistically significant. CONCLUSIONS: No significant association was observed between percutaneous CT-guided lung biopsy and intraoperative pleural lavage cytology results, even in patients with stage IA disease. Percutaneous CT-guided lung biopsy with a coaxial needle does not seem to cause pleural dissemination.

KW - Cytology

KW - Lavage

KW - Lung cancer

KW - Malignant pleural effusion

KW - Needle biopsy

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DO - 10.1002/cncr.24620

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