CT-guided percutaneous lung biopsies in patients with haematologic malignancies and undiagnosed pulmonary lesions

Sanjay Gupta, Mark Sultenfuss, Jorge E. Romaguera, Joe Ensor, Savitri Krishnamurthy, Michael J. Wallace, Kamran Ahrar, David C. Madoff, Ravi Murthy, Marshall E. Hicks

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

We searched the electronic patient database at The University of Texas M. D. Anderson Cancer Center for patients who underwent computed tomography (CT)-guided needle biopsy between January 2001 and December 2005. Inclusion criteria were a known history of haematologic malignancy and a newly detected, undiagnosed pulmonary lesion on chest CT that required tissue sampling for diagnosis; 213 met these criteria. We analysed the biopsy results for diagnostic yield, factors affecting diagnostic yield and effect on treatment. Of 213 procedures, 191 (89.7%) yielded sufficient material for pathologic analysis; 130 (60%) yielded specific diagnoses, while 61 (28.6%) yielded nonspecific benign diagnoses. Lesions larger than 1 cm, cavitary lesions and lung masses were more likely to yield a specific diagnosis than were lesions smaller than 1 cm, lung nodules and consolidations. The most common specific diagnoses were malignancy (62.8%) and infection (34.3%). The latter was more common in patients with leukaemia, cavitary lung lesions or consolidations, active underlying malignancy, neutropenia, respiratory signs and symptoms and/or fever, bone marrow transplant recipients, and in patients receiving chemotherapy. Lung lesions discovered upon follow-up imaging in patients who did not have any respiratory signs/symptoms or fever were mostly malignant. Therapeutic changes were more likely after a specific diagnosis than after a nonspecific diagnosis or a nondiagnostic biopsy (88.4% vs. 18.1%; p<0.0001). CT-guided lung biopsy has a high diagnostic yield in patients with haematologic malignancies that present with unexplained pulmonary lesions and provides a specific diagnosis in a majority of these patients, leading to therapeutic changes.

Original languageEnglish (US)
Pages (from-to)75-81
Number of pages7
JournalHematological Oncology
Volume28
Issue number2
DOIs
StatePublished - Jun 2010

Keywords

  • Computed tomography
  • Haematologic malignancy
  • Percutaneous biopsy
  • Pulmonary lesions

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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