Percutaneous transthoracic lung biopsy:a pathological analysis of 642 cases

Purpose To investigate the value of percutaneous transthoracic biopsy in the pathological diagnosis for pulmonary lesions.Methods The clinicopathologic data of 642 patients with CT-guided percutaneous transthoracic biopsy of pulmonary lesions were retrospectively analyzed and summarized with review of literatures.Results Among 642 cases,the accurate diagnosis accounted for 533 cases(83.0%),descriptive pathological diagnosis was 98 cases(15.3%),and the diagnosis without any clinical significance was 11 cases(1.7%),respectively.280 cases(52.5%) were diagnosed as primary lung tumors and tumor-like lesions,of which 239 cases were malignant epithelial tumors(85.4%),including adenocarcinoma in 129 cases(54.0%);11 cases(3.9%) were diagnosed as mesenchymal tumours,of which inflammatory myofibroblastic tumours were 3 cases(27.3%);14 cases(5.0%) were diagnosed as lymphoma,4 casess(1.4%) were diagnosed as thymoma;metastatic tumors to the lung were 18 cases(3.4%);235 cases(44.1%) were diagnosed as non-neoplastic lesions,of which granulomatous inflammatory lesions were 61 cases(26.0%) including 29 cases of tuberculosis,7 cases of fungous infection(pulmonary cryptococcosis,2 cases),and 2 cases of granulomatosis,and non-specific inflammatory lesions were 174 cases(74.0%).Conclusions Percutaneous transthoracic biopsy is an effective approach to diagnose pulmonary lesions,especially determining the nature of peripheral tumors and diffuse pulmonary diseases.The use of immunohistochemistry plays an important role in determining the nature of lung lesions,improving the accuracy of pathological diagnosis,and reducing unnecessary repeated examinations.