Avtor/Urednik		Svetina-Šorli, Petra; Debeljak, Andrej; Triller, Nadja; Kecelj, Peter; Letonja, Saša; Marčun, Robert; Kern, Izidor; Cesar, Rok
Naslov		Transtorakalna igelna aspiracijska biopsija sprememb v pljučih, na plevri in v mediastinumu
Prevedeni naslov		Transthoracic needle aspiration biopsy of pulmonary, pleural, and mediastinal lesions
Tip		članek
Vir		Endoskopska revija
Vol. in št.		Letnik 8, št. 20-21
Leto izdaje		2003
Obseg		str. 121-6
Jezik		slo
Abstrakt		Background. Transthoracic needle aspiration biopsy (TTNAB) is indicated in diagnostic workup of the diseases of the lung, pleura, thoracic wall and mediastinum if less invasive procedures have failed. We wanted to find out the number, sensitivity and possible complications of procedures performed in one year, the location of the disease, the type of the needle and under what guidance the procedure was done. Methods. We analysed retrospectively the medical records of 94 patients in whom 99 TTNAB were performed at The University Clinic of Respiratory and Allergic Diseases Golnik from June 1st 2001 to May 31st 2002. The procedure was applied in 63 male (67%) and 31 female (33%) patients, aged 63,9 +/- 11,3 years. Nordenstrom needle was applied in all cases, and Rotex needle additionally in ll patients. Biopsies were performed under fluoroscopic computer tomography (CT) or ultrasound (US) guidance. The samples obtained were examined cytologically. Results. The majority of procedures 84 (85%) were performed under fluoroscopic guidance, 10 (10%) under CT and 5 (5%) under US guidance. Lesions were observed in the lung in 86 (87%), in the mediastinum in 8 (8%), and in the pleura in 5 (5%) patients. Cytological examination confirmed malignant disease in 58 cases (58.5%), benign diseases in 38 cases (38,5%), inflammation in 33 (33.3%), and benign tumours in 5 cases (5.1%). Samples not suitable for cytological examinations were obtained in 3 cases (3%). Overall sensitivity of the examination was 84.3% (81/96). The sensitivity in the patients with malignant diseases was 87.9% (51/58) with the specificity of 95%. The sensitivity in the patients with benign diseases was 78.9% (30/38). Pneumothorax was confirmed in 11% (11/99) of examinations, pleural drainage was necessary in 2 and exsufflation in 1 patient, other pneumothoraces resolved without intervention. In 1 patient haemoptyses were observed and ceased spontaneously. (Abstract truncated at 2000 characters).
Izvleček		Izhodišča. S transtorakalno igelno aspiracijsko biopsijo (TTIAB) pljuč, plevre, stene prsnega koša in mediastinuma skušamo opredeliti spremembe, ki jih z manj invazivnimi diagnostičnimi preiskavami nismo uspeli opredeliti. Zanimalo nas je število opravljenih preiskav v obdobju enega leta, lokalizacija opazovanih sprememb, uspešnost preiskave glede na tip punkcijskih igel, način vodenja punkcije (rentgen, računalniška tomografija - CT, ultrazvok -UZ), občutljivost preiskovalne metode in morebitne zaplete. Občutljivost preiskave za maligne in benigne spremembe smo primerjali z raziskavo iz leta 1998. Metode. Retrospektivno smo analizirali dokumentacijo 94 bolnikov, obravnavanih v Bolnišnici Golnik, pri katerih smo od 1. junija 2001 do 31. maja 2002 opravili 99 TTIAB. Preiskavo smo opravili pri 63 moških (67%) in 31 ženskah (33%), starih 63,9 +/- 11,3 let, pod nadzorom rentgena, CT ali UZ. Pri vseh bolnikih smo uporabljali Nordenstromovo, pri 11 tudi Rotexovo iglo. Vzorce smo citološko pregledali. Rezultati. Največ biopsij, 84 (85%), smo opravili pod nadzorom rentgena, 10 (10%) pod nadzorom CT in 5 (5%) z UZ. Pri 5 bolnikih smo punkcijo ponovili. Pri 86 bolnikih (87%) so bile opazovane spremembe v pljučnem parenhimu, pri 8 (8%) v mediastinumu in pri 5 (5%) v plevri. Glede na citološki izvid smo s pregledom 58 vzorcev (58,5%) ugotovili maligne bolezni, 38 vrorcev (38,5%) je bilo benigne narave: 33 vnetnih sprememb (33,3%) in 5 (5,1%) benignih tumorjev. Za citološki pregled neustrezen material smo dobili pri 3 punkcijah (3%). Maligne bolezni je imelo 57 (61%) bolnikov (en bolnik na dveh mestih) in benigno bolezen 37 (39%) bolnikov. Občutljivost preiskave je bila v celoti 84,3% (81/96), pri bolnikih z malignimi boleznimi 87,9% (51/58), specifičnost 95%. Občutljivost preiskave pri bolnikih z benignimi boleznimi je bila 78,9% (30/38). (Izvleček skrajšan pri 2000 znakih).
Deskriptorji		LUNG NEOPLASMS PLEURAL DISEASES MEDIASTINAL NEOPLASMS BIOPSY, NEEDLE PNEUMOTHORAX