Minimally invasive, ionizing-free, and ultrasound-guided technique to biopsy anterior mediastinal masses: first 60 cases

Our plain-English summary of Minimally invasive, ionizing-free, and ultrasound-guided technique to biopsy anterior mediastinal masses: first 60 cases, by B. Lorenzati, R. Cristofori, A. Landi, et al (Panminerva Medica, 2018).

The study

• Authors: B. Lorenzati, R. Cristofori, A. Landi, E. Ruffini, D. Novero, G. Lauria, B.M. Tartaglino, A. Oliaro, L. Scaglione, E. Rolfo
• Journal: Panminerva Medica
• Published: 2018;60(3):132-133
• Type of article: Letter
• Read it: PubMed · Publisher

In plain English

This letter to the editor reported a single-center, retrospective review of 60 consecutive patients who had core needle biopsies of masses in the anterior mediastinum (the front part of the chest between the lungs). The biopsies were done at a center in Turin, Italy, from April 2011 to December 2015. Each biopsy was guided by ultrasound, so no ionizing radiation was used, and was done under local anesthesia with a large-bore needle. Most diagnoses were blood cancers (39 of 60 patients). Two of 60 patients had mesothelioma. The article did not describe these mesotheliomas further and did not mention asbestos. An adequate diagnostic tissue sample was obtained in 210 of 224 needle passes (93%), and 2 patients needed a different procedure to get a sample. No major complications or deaths were observed, and 3 minor complications occurred. The authors concluded that the technique was technically feasible, accurate and safe, and called for larger multicenter studies. They noted the small number of cases, the retrospective design, a likely selection bias toward blood cancers, and that the same two physicians did all the biopsies.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Single-center retrospective review of consecutive ultrasound-guided core needle biopsies (case series), published as a letter to the editor
• Who was studied: 60 patients with anterior mediastinal masses biopsied at the Vascular Diagnostics and Ultrasound Assisted Procedures Centre, Città della Salute e della Scienza, Turin, Italy, April 2011 to December 2015. Mean age was 45.5 years, the male-to-female ratio was 28:32, and the outpatient-to-inpatient ratio was 42:18.
• Main results:
  • Blood (hematologic) cancers were found in 39 of 60 patients (64.6% as printed).
  • Mesothelioma was diagnosed in 2 of 60 patients (3.3%). The type and site were not specified.
  • An adequate and diagnostic tissue sample was obtained in 210 of 224 needle passes (93%). Only 2 patients needed a different approach (one CT-guided biopsy, one thoracotomy).
  • Material was inadequate in 4 of 60 patients (6.6%) and 14 of 224 needle passes (7%), and the biopsy was repeated with the same technique.
  • No major complications or deaths were observed. There were 3 minor complications (5%): bleeding into the muscle, a pseudoaneurysm of a superficial vein, and coughing up blood.
• The authors' conclusion: The authors concluded that ultrasound-guided biopsy of anterior mediastinal masses is technically feasible, accurate and safe, and that larger and multicenter studies are required.
• Limitations the authors state:
  • The number of biopsies was relatively small and the design was retrospective.
  • The high share of blood cancers was probably due to selection bias.
  • All biopsies were performed by the same two physicians, which may limit how far the results apply elsewhere.

Topics

Medical terms in this study, explained in our Lexicon: Ultrasound, Biopsy.

Related studies

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• Physician-based ultrasound-guided biopsy for diagnosing pleural disease — R.J. Hallifax, J.P. Corcoran, et al. (2014)
• Surgery for invasive primary mediastinal tumors — E.A. Bacha, A.R. Chapelier, et al. (1998)
• Advantages of thoracic ultrasound-guided fine-needle aspiration biopsy in lung cancer and mesothelioma — M. Sperandeo, L. Dimitri, et al. (2014)
• Endobronchial ultrasound-guided transbronchial needle aspiration in a patient with pericardial mesothelioma — H. Ashinuma, M. Shingyoji, et al. (2015)
• A Single-Institution Experience in Percutaneous Image-Guided Biopsy of Malignant Pleural Mesothelioma — B.T. Welch, P.W. Eiken, et al. (2017)

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