- 作者：Wahid H. Tantawy ; Emad H. El-Gemeie ; Ahmed S. Ibrahim ; Mona A. Mohamed
- 关键词：CT guided biopsy ; Paravertebral ; Lymph node ; Fine needle aspiration cytology (FNAC)
- 刊名：European Journal of Radiology
- 出版年：2012
- 出版时间：October, 2012
- 年：2012
- 卷：81
- 期：10
- 页码：2907-2912
- 全文大小：730 K
Purpose
To report our experience in CT guided extrapleural paravertebral subcarinal lymph biopsy using a thin 25 gauge (25 G) thin needle without the need of injection of saline to widen the mediastinum.Materials and methods
Biopsy was performed using a 25 G needle which was advanced lateral to the vertebral body between the endothoracic fascia and the parietal pleura to gain access to subcarinal lymph nodes. One hundred and forty one patients were included in the study (74 females, 57 males). No artificial widening of the mediastinum using saline injection was required. The study was performed in the presence of a cytopathologist; sensitivity and specificity rates were calculated. Complications were documented for each case especially for pneumothorax and haemorrhage.
Results
Cytopathological diagnosis was reached in all cases. All re-aspirations were done in the same session to reach a primary diagnosis at the time of the biopsy. Imunophenotyping study was done in 94 cases to confirm the primary diagnosis and to classify the malignant lesions. No pneumothorax was encountered. Small haematomas were noted in 5 cases (3.5 % ). Cytopathology showed a sensitivity of 97.2 % and specificity of 100 % . By adding immunophenotyping a 100 % sensitivity and specificity was achieved.
Conclusion
Fine needle aspiration cytology (FNAC) using a 25 gauge needle for subcarinal lymph nodes via a percutaneous extrapleural paravertebral CT guided approach is a safe, minimally invasive, and tolerable procedure yielding a high sensitivity and specificity rates without the need of artificial widening.