Pulmonary needle aspiration biopsy in the diagnosis of Pancoast tumors

Our plain-English summary of Pulmonary needle aspiration biopsy in the diagnosis of Pancoast tumors, by W.J. Walls, J.R. Thornbury, B. Naylor (Radiology, 1974).

The study

• Authors: W.J. Walls, J.R. Thornbury, B. Naylor
• Journal: Radiology
• Published: 1974;111(1):99-102
• Cited by: 46 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Twenty-seven patients with Pancoast tumors underwent fluoroscopically guided pulmonary needle aspiration biopsy, a diagnostic procedure which provided a cellular aspirate rather than a core of tissue. Diagnoses were made by cytologic rather than histologic techniques. A diagnosis of carcinoma was made in 26 of the 27 cases. The remaining tumor was a locally invasive pleural fibrous mesothelioma. Pulmonary needle aspiration biopsy gave diagnostic results far superior to those obtained by bronchoscopic biopsy, cytology of sputum or bronchial washings, or biopsy of scalene or supraclavicular lymph nodes.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This article described 27 patients with Pancoast tumors, which are tumors at the very top of the lung. They were seen at the University of Michigan Medical Center and all had a fluoroscopically guided needle aspiration biopsy. The patients were 25 men and 2 women aged 33 to 75. Thirty aspirations were performed. Needle aspiration gave a positive diagnosis of lung carcinoma in 26 of the 27 patients, most often squamous-cell carcinoma (14 of 27). The remaining tumor was a locally invasive pleural fibrous mesothelioma. Sputum cytology found carcinoma in only 2 of 18 patients tested. Bronchoscopic biopsy, bronchial washings and lymph node biopsy were negative in every case in which they were done. Pneumothorax (collapsed lung) followed 3 of the 30 procedures. Seven diagnoses were confirmed by surgery or autopsy. Six could not yet be confirmed. The authors concluded that needle aspiration gave results far superior to the other procedures and carried little morbidity. The article does not discuss asbestos or any patient's exposure history.

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: Retrospective review of a case series (one institution's clinical experience with a diagnostic procedure)
• Who was studied: 27 patients with Pancoast tumors seen at the University of Michigan Medical Center, 1966 to 1972; ages 33 to 75; 25 men and 2 women; 30 aspirations in total
• Exposure: No asbestos or other environmental or occupational exposure was studied. The article concerns a diagnostic procedure (fluoroscopically guided needle aspiration biopsy).
• Main results:
  • Needle aspiration gave a positive diagnosis of pulmonary carcinoma in 26 of the 27 patients
  • The one remaining tumor was a locally invasive pleural fibrous mesothelioma. It was diagnosed only after 2 negative aspirations and a third suggestive one, and confirmed at surgery.
  • Squamous-cell carcinoma was the most common type, in 14 of the 27 cases
  • Sputum cytology diagnosed carcinoma in only 2 of the 18 patients in whom it was performed
  • Bronchoscopic biopsy, bronchial washings cytology, and scalene or supraclavicular lymph node biopsy were negative in all cases in which they were done
  • The only complication was pneumothorax, after 3 of the 30 procedures
  • Of the 27 aspiration diagnoses, 7 were confirmed histologically by surgery or necropsy
  • 15 of the 27 patients had rib erosion on radiographs or laminagraphy
• The authors' conclusion: The authors concluded that pulmonary needle aspiration biopsy gave diagnostic results far superior to bronchoscopic biopsy, sputum or bronchial washing cytology, and lymph node biopsy, and that it carried little morbidity.
• Limitations the authors state:
  • In 14 patients the cytologic diagnosis was not confirmed by surgery or necropsy; the authors relied on clinical course and death
  • For 6 patients the diagnosis had not been confirmed or refuted, owing to no surgery or necropsy or too short follow-up

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Biopsy, Aspirate, Carcinoma, Mesothelioma, Cytology, Sputum.

Related studies

• Electron microscopy in the diagnosis of percutaneous fine needle aspiration specimens — E.J. Wills, S. Carr, et al. (1987)
• Diagnosis of malignant mesothelioma by fine needle aspiration of a cervical lymph node. A case report — N.A. Ansari, N.W. Derias (2000)
• Advantages of thoracic ultrasound-guided fine-needle aspiration biopsy in lung cancer and mesothelioma — M. Sperandeo, L. Dimitri, et al. (2014)
• Pulmonary acantholytic squamous cell carcinoma with focal signet ring cell morphology mimicking malignant mesothelioma on fine needle aspiration cytology: a case report — S.E. Choi, H.S. Park (2016)
• The role of endobronchial ultrasound-guided fine needle aspiration in the diagnosis of pleural mesothelioma — M.R. Ghigna, A. Crutu, et al. (2016)
• Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions: a randomized, controlled trial — M. Metintas, G. Ak, et al. (2010)

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