Percutaneous Needle Aspiration Biopsy (PCNA) of Pulmonary Lesions: Evaluation of a Reaspiration or a Rebiopsy (second PCNA)

Department of Radiology, Hallym University College of Medicine, Seoul, Korea Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea Department of Occupational Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea Received February 1, 2008 ; Accepted March 31, 2008 Address reprint requests to : In Jae Lee, M.D., Ph.D., Department of Radiology, Hallym University Sacred Heart Hospital, 896, Pyungchon-dong, Dongangu, Anyang-si, Gyeonggi-do 431-070, Korea. Tel. 82-31-380-3885 Fax. 82-31-380-3878 E-mail: [email protected] Purpose: To evaluate the effectiveness of the reaspiration or rebiopsy of pulmonary lesions (second PCNA) in cases where the pathologic results are inconclusive upon initial percutaneous needle aspiration biopsy (PCNA). Materials and Methods: A total of 364 PCNA cases (350 initial PCNA, 14 second PCNA) were performed under CT or fluoroscopy guidance for all the 350 patients enrolled. The procedure was performed by either using an automated biopsy gun with a 20-G needle (298 cases) or a 20-G aspiration needle (66 cases). The pathologic agreement rates between the initial and second PCNA, as well as the causes for a second PCNA, were evaluated. Finally the type and rate of complication were also evaluated. Results: The second PCNA rate was 4.0% (14/350). The causes for a second PCNA, following the initial PCNA included unexpected pathologic results (n = 7) and inconclusive pathologic results (n = 7). Of the seven cases which had unexpected pathologic results from their initial PCNAs, five had similar pathologic results after a second PCNA. Also, of the seven cases of inconclusive pathologic results, such as atypical cells, the scanty cellularity or necrosis upon an initial PCNA, six cases revealed a malignancy on a second PCNA. The overall complication rate, including both the initial and second PCNAs was 14.0% (51/364). Conclusion: A second PCNA was performed to help resolve the exact diagnosis for a pulmonary lesion in cases of inconclusive pathologic results upon an initial PCNA.