Computerized tomography guided percutaneous transthoracic fine needle aspiration of lung lesions

Introduction: Computed tomogram guided fine needle aspiration cytology (FNAC) is an important and useful investigation to differentiate between benign and malignant lesions of lungs. With computed tomography (CT) it is possible to perform a biopsy on almost any portion of lung with high degree of safety and minimal morbidity avoiding more invasive techniques. Aim: The present study was designed to assess the efficacy of CT guided fine needle aspiration of lung lesions and to assess the incidence of complications. Materials and methods: 65 cases of both sex and varying age groups referred to radiology department for CT guided lung FNAC from October 2012 to January 2013 were included in this study. Relevant clinical history and investigations were obtained from the patient. Informed and written consent was taken from the patient. The lesions were localized by CT scan and after the needle tip was confirmed to be in the desired location, aspirations were performed. Results: A total 65 cases, 53 cases were male and 12 cases were female with mean age 49.23 years. The most common diagnosis observed following biopsy was malignancy (non small cell carcinoma) in 41 cases (63%), benign lesion in 6 cases (9%) and 3% showed mixed lesions. Among 65 cases, 49 cases (75%) showed adequate material in the aspirate specimen, where as 12 cases (18.4%) showed inadequate tissue for diagnosis. However 4 cases were lost on follow up. Complications observed during procedure include pneumothorax in 11 cases (16.9%) and hemoptysis/pulmonary hemorrhage in 2 cases (3%). Conclusion: CT guided FNAC is well recognized procedure with good efficacy for evaluation of pulmonary lesions with minimal complications, most common being pneumothorax followed by hemoptysis.