ABSTRACT

Transthoracic lung biopsy (TTLB) with fine needle Chiba type and Tru-cut thick cutting biopsies, computerized tomography (CT) scan guided lung biopsies in the diagnosis of peripheral lung lesions. Objective: Compare the diagnostic certainty (TTLB) with Chiba and Tru-cut biopsy in the same patient, and evaluate if the combination of both improves the certainty in the diagnosis, without increasing complications. Material and methods: Forty-nine adult patients with pulmonary lesions were studied from April 2013 to April 2016 at a 2nd level hospital. All patients were biopsied a Chiba needle, followed by a Tru-cut which were analyzed by 2 different pathologists. Results: Two patients were eliminated due do not having complete results. Of the 47 studied patients 34 (72%) were male and 13 (28%) female, their age range was 42-86 and average 68.9 years old. With the Chiba technique, 95% of the patients were diagnosed: 41 malignant, 4 benign and 2 false negatives that required minor surgery (thoracoscopy and mini-thoracotomy) for diagnosis. With Tru-cut, 87%: 38 malignant, 9 negative to malignancy: 9 benign (2 of them were malignant with Chiba) and 5 false negatives (3 malignant with Chiba and 2 minor surgery); and 4 bening pathologies (2 infections, 1 hamartoma and 1 pulmonary atelectasis). Most frequent histological types in both techniques were epidermoid and adenocarcinoma. The benign causes were: Hamartoma, infectious and lung atelectasis. The Chiba reported sensitivity 0.95, specificity 1, VPP1, NPV 0.66, false negatives 0.04. The Tru-cut was 0.89, 1.1, 0.44 and 0.11 respectively. Neither technique gave false positives. The main complication was pneumothorax. Conclusions: The Chiba needle was slightly superior to Tru-cut in diagnostic certainty. The employment to technique followed the other in the same patient, increased the certainty of the diagnostic, but not the complications.

KEYWORDS

Transthoracic lung biopsy, computerized tomography, needle Chiba, needle Tru-cut, diagnostic certain.

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