Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019, 163(3):220-226 | DOI: 10.5507/bp.2018.058

CT-guided biopsy of the mediastinal masses. Can anatomical relationships predict complications?

Petr Dvoraka, Petr Hoffmanna, Eva Kocovaa, Petr Habalb, Marketa Novac
a Department of Radiology, University Hospital, Hradec Kralove, Czech Republic
b Department of Cardiac and Thoracic Surgery, University Hospital, Hradec Kralove, Czech Republic
c The Fingerland Department of Pathology, University Hospital, Hradec Kralove, Czech Republic

Aim: To retrospectively evaluate the technical features, feasibility, efficacy, accuracy and appropriate complications of CT-guided biopsies of mediastinal masses and correlate them with anatomical relationships in the mediastinum.

Methods: Over the course of ten years, 81 percutaneous biopsy procedures in 78 patients for tumors sizes 27 - 189 mm in diameter (median length 57.5 mm) were performed using only local anesthesia. These interventions were done under the guidance of computed tomography. The patients were men in 30 cases and women in 48 cases, aged 19 to 90 years.

Results: In 78 cases (96.3%) results were either true positive or true negative; in only 3 cases (3.7%, 3 biopsies of 2 tumors in 2 patients) were histological findings false negative. In 2.3% of the patients, complications were revealed in the anterior part of the mediastinum, 43.7% occurred in the middle region, and 14.3% in the posterior region of the mediastinum. Statistical data analysis verified there was a 3.74 times chance of an increase in complications in the middle mediastinal section in correlation with other anatomical localizations. In only one case was therapeutic intervention for complication necessary. For all other cases, a conservative approach was suitable.

Conclusion: Percutaneous CT guided biopsies of the mediastinal tumors has a high accuracy rate in establishing the correct diagnosis. Masses in the middle mediastinum are associated with statistically higher incidences of postprocedural complications, which are not serious.

Keywords: percutaneous biopsy, mediastinal tumors, minimally invasive diagnosis, biopsy complications

Received: May 17, 2018; Revised: July 20, 2019; Accepted: September 14, 2018; Prepublished online: September 24, 2018; Published: September 23, 2019  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Dvorak, P., Hoffmann, P., Kocova, E., Habal, P., & Nova, M. (2019). CT-guided biopsy of the mediastinal masses. Can anatomical relationships predict complications? Biomedical papers, 163(3), 220-226. doi: 10.5507/bp.2018.058
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Dähnert W. Radiology Review Manual, 7th ed. Philadelphia, Lippincott Williams & Wilkins, 1264 pp., 2011.
    2. Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L. A Diagnostic Approach to the Mediastinal Masses. Insights Imaging 2013;4(1):29-52. Go to original source... Go to PubMed...
    3. Pearson JK, Tan GM. Pediatric Anterior Mediastinal Mass: A Review Article. Semin Cardiothorac Vasc Anesth 2015;19(3):248-54. Go to original source... Go to PubMed...
    4. Liu T, Al-Kzayer LFY, Xie X, Fan H, Sarsam SN, Nakazawa Y, Chen L. Mediastinal lesions across the age spectrum: a clinicopathological comparison between pediatric and adult patients. Oncotarget 2017;8(35):59845-53. Go to original source... Go to PubMed...
    5. Mondoni M, D'Adda A, Terraneo S, Carlucci P, Radovanovic D, Di Marco F, Santus P. Choose the best route: ultrasound-guided transbronchial and transesophageal needle aspiration with echobronchoscope in the diagnosis of mediastinal and pulmonary lesions. Minerva Med 2015;106(5 Suppl 1):13-9. Go to PubMed...
    6. Ku¿d¿a³ J, Szlubowski A. Ultrasound-guided transbronchial and transesophageal needle biopsy in the mediastinal staging of lung cancer. Thorac Surg Clin 2012;22(2):191-203. Go to original source... Go to PubMed...
    7. Dhooria S, Aggarwal AN, Gupta D, Behera D, Agarwal R. Utility and Safety of Endoscopic Ultrasound With Bronchoscope-Guided Fine-Needle Aspiration in Mediastinal Lymph Node Sampling: Systematic Review and Meta-Analysis. Respir Care 2015;60(7):1040-50. Go to original source... Go to PubMed...
    8. Badaoui A, Dahlqvist C, Rahier J, Weynand B, Ocak S, Deprez P, Eucher P, Duplaquet F. Combined endoscopic ultrasonography and endobronchial ultrasound-fine-needle aspiration for evaluation of mediastinal lymph nodes. Endosc Ultrasound 2014;3(3 Suppl 1):S9.
    9. Grosu HB, Iliesiu M, Caraway NP, Medeiros LJ, Lei X, Jimenez CA, Morice RC, Casal RF, Ost D, Eapen GA. Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis and Subtyping of Lymphoma. Ann Am Thorac Soc 2015;12(9):1336-44. Go to original source... Go to PubMed...
    10. Ceuterick V, Decaluwé H, Coosemans W, Nafteux P, Van Veer H, Van Raemdonck D, De Leyn P. Esophageal wall rupture after EUS-FNA for mediastinal staging: report of two cases. Acta Chir Belg 2016;116(1):48-50. Go to original source... Go to PubMed...
    11. Çağlayan B, Yilmaz A, Bilaçeroğlu S, Cömert Sª, Demirci NY, Salepçi B. Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study. Respir Care 2016;61(2):243-8.
    12. Onat S, Ates G, Avci A, Yildiz T, Birak A, Akgul Ozmen C, Ulku R. The role of mediastinoscopy in the diagnosis of non-lung cancer diseases. Ther Clin Risk Manag 2017;13:939-43. Go to original source... Go to PubMed...
    13. Habal P, Simek J. Videothoracoscopy, standard and uncommon indications. Rozhl Chir 2007;86(8):442-7. Go to PubMed...
    14. Bilgin Büyükkarabacak Y, Taslak ªengül A, Meydan BC, Çelik B, Pirzirenli MG, Gürz S, Sürücü ZP, Baºoğlu A. The risk of tumor cell dissemination in mediastinoscopy: a cytological study. Turk J Med Sci 2015;45(4):872-6. Go to original source... Go to PubMed...
    15. Elsayed H. Haemothorax after mediastinoscopy: a word of caution. Eur J Cardiothorac Surg 2012;41(1):138-9.
    16. Billè A, Longman C, Pilling J. Aortic pseudoaneurysm: a rare complication of mediastinoscopy. Gen Thorac Cardiovasc Surg 2013;61(3):160-2. Go to original source... Go to PubMed...
    17. Priola AM, Priola SM, Cataldi A, Ferrero B, Garofalo G, Errico L, Marci V, Fava C. CT-guided percutaneous transthoracic biopsy in the diagnosis of mediastinal masses: evaluation of 73 procedures. Radiol Med 2008;113(1):3-15. Go to original source... Go to PubMed...
    18. Petranovic M, Gilman MD, Muniappan A, Hasserjian RP, Digumarthy SR, Muse VV, Sharma A, Shepard JA, Wu CC. Diagnostic Yield of CT-Guided Percutaneous Transthoracic Needle Biopsy for Diagnosis of Anterior Mediastinal Masses. AJR Am J Roentgenol 2015;205(4):774-9. Go to original source... Go to PubMed...
    19. de Margerie-Mellon C, de Bazelaire C, Amorim S, Brice P, Tazi A, Brière J, Frija J, de Kerviler E. Diagnostic Yield and Safety of Computed Tomography-guided Mediastinal Core Needle Biopsies. J Thorac Imaging 2015;30(5):319-27. Go to original source... Go to PubMed...
    20. Kulkarni S, Kulkarni A, Roy D, Thakur MH. Percutaneous computed tomography-guided core biopsy for the diagnosis of mediastinal masses. Ann Thorac Med 2008;3(1):13-7. Go to original source... Go to PubMed...
    21. Kim H, Park CM, Lee SM, Goo JM. C-Arm Cone-Beam CT Virtual Navigation-Guided Percutaneous Mediastinal Mass Biopsy: Diagnostic Accuracy and Complications. Eur Radiol 2015;25(12):3508-17. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content