Role of fine-needle aspirates of focal lung lesions in patients with hematologic malignancies

Philip W. Wong, Tihomir Stefanec, Karen Brown, Dorothy A. White

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objectives: To evaluate the yield and safety of transthoracic fine-needle aspiration (FNA) in the diagnosis of pulmonary disease in patients with hematologic malignancy. Design: Retrospective chart review. Setting: Tertiary-care medical center. Patients: Sixty-seven patients with a hematologic malignancy or after bone marrow transplantation (BMT) for a hematologic malignancy who underwent a total of 71 FNAs for diagnosis of an unexplained parenchymal lung lesion from January 1, 1991, to June 30, 1999. Results: The underlying malignancy was lymphoma in 42 patients (63%), leukemia in 8 patients (12%), after allogeneic BMT in 12 patients (18%), after autologous BMT in 3 patients (4%), and other diseases in 2 patients. Radiographs showed focal abnormalities in all cases, and were nodules in 37%, masses in 37%, focal infiltrates in 21%, and cavitary lesions in 5%. The yield of FNA for a finding specific infection or cancer was 56% (40 of 71 FNAs). The FNA with inflammatory changes was clinically sufficient in another 11 patients for a total yield of 72% (51 of 71 FNAs). The yield for lung cancer was 90% (9 of 10 FNAs), for pulmonary lymphoma was 68% (21 of 31 FNAs), and for infection was 67% (10 of 15 FNAs). Complications occurred in 18 of 71 FNAs (25%), with pneumothorax in 14 patients (20%) and chest tube placement required in 4 patients (6%). Bleeding occurred in six patients (8%), including one death in a patient with abnormal hematologic parameters. Conclusion: Transthoracic FNA in patients with hematologic malignancy and focal lung lesions has an excellent yield for detecting cancer and a yield comparable to bronchoscopy for the diagnosis of infections. It should be considered a useful diagnostic tool in this setting.

Original languageEnglish (US)
Pages (from-to)527-532
Number of pages6
JournalChest
Volume121
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Hematologic Neoplasms
Needles
Lung
Fine Needle Biopsy
Bone Marrow Transplantation
Lymphoma
Infection
Chest Tubes
Neoplasms
Autologous Transplantation
Homologous Transplantation
Bronchoscopy
Pneumothorax
Tertiary Care Centers
Lung Diseases
Lung Neoplasms
Leukemia

Keywords

  • Fine-needle lung aspirate
  • Immunocompromised patient
  • Invasive radiology
  • Lung cancer
  • Transthoracic needle aspiration

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Role of fine-needle aspirates of focal lung lesions in patients with hematologic malignancies. / Wong, Philip W.; Stefanec, Tihomir; Brown, Karen; White, Dorothy A.

In: Chest, Vol. 121, No. 2, 2002, p. 527-532.

Research output: Contribution to journalArticle

Wong, Philip W. ; Stefanec, Tihomir ; Brown, Karen ; White, Dorothy A. / Role of fine-needle aspirates of focal lung lesions in patients with hematologic malignancies. In: Chest. 2002 ; Vol. 121, No. 2. pp. 527-532.
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abstract = "Objectives: To evaluate the yield and safety of transthoracic fine-needle aspiration (FNA) in the diagnosis of pulmonary disease in patients with hematologic malignancy. Design: Retrospective chart review. Setting: Tertiary-care medical center. Patients: Sixty-seven patients with a hematologic malignancy or after bone marrow transplantation (BMT) for a hematologic malignancy who underwent a total of 71 FNAs for diagnosis of an unexplained parenchymal lung lesion from January 1, 1991, to June 30, 1999. Results: The underlying malignancy was lymphoma in 42 patients (63{\%}), leukemia in 8 patients (12{\%}), after allogeneic BMT in 12 patients (18{\%}), after autologous BMT in 3 patients (4{\%}), and other diseases in 2 patients. Radiographs showed focal abnormalities in all cases, and were nodules in 37{\%}, masses in 37{\%}, focal infiltrates in 21{\%}, and cavitary lesions in 5{\%}. The yield of FNA for a finding specific infection or cancer was 56{\%} (40 of 71 FNAs). The FNA with inflammatory changes was clinically sufficient in another 11 patients for a total yield of 72{\%} (51 of 71 FNAs). The yield for lung cancer was 90{\%} (9 of 10 FNAs), for pulmonary lymphoma was 68{\%} (21 of 31 FNAs), and for infection was 67{\%} (10 of 15 FNAs). Complications occurred in 18 of 71 FNAs (25{\%}), with pneumothorax in 14 patients (20{\%}) and chest tube placement required in 4 patients (6{\%}). Bleeding occurred in six patients (8{\%}), including one death in a patient with abnormal hematologic parameters. Conclusion: Transthoracic FNA in patients with hematologic malignancy and focal lung lesions has an excellent yield for detecting cancer and a yield comparable to bronchoscopy for the diagnosis of infections. It should be considered a useful diagnostic tool in this setting.",
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N2 - Objectives: To evaluate the yield and safety of transthoracic fine-needle aspiration (FNA) in the diagnosis of pulmonary disease in patients with hematologic malignancy. Design: Retrospective chart review. Setting: Tertiary-care medical center. Patients: Sixty-seven patients with a hematologic malignancy or after bone marrow transplantation (BMT) for a hematologic malignancy who underwent a total of 71 FNAs for diagnosis of an unexplained parenchymal lung lesion from January 1, 1991, to June 30, 1999. Results: The underlying malignancy was lymphoma in 42 patients (63%), leukemia in 8 patients (12%), after allogeneic BMT in 12 patients (18%), after autologous BMT in 3 patients (4%), and other diseases in 2 patients. Radiographs showed focal abnormalities in all cases, and were nodules in 37%, masses in 37%, focal infiltrates in 21%, and cavitary lesions in 5%. The yield of FNA for a finding specific infection or cancer was 56% (40 of 71 FNAs). The FNA with inflammatory changes was clinically sufficient in another 11 patients for a total yield of 72% (51 of 71 FNAs). The yield for lung cancer was 90% (9 of 10 FNAs), for pulmonary lymphoma was 68% (21 of 31 FNAs), and for infection was 67% (10 of 15 FNAs). Complications occurred in 18 of 71 FNAs (25%), with pneumothorax in 14 patients (20%) and chest tube placement required in 4 patients (6%). Bleeding occurred in six patients (8%), including one death in a patient with abnormal hematologic parameters. Conclusion: Transthoracic FNA in patients with hematologic malignancy and focal lung lesions has an excellent yield for detecting cancer and a yield comparable to bronchoscopy for the diagnosis of infections. It should be considered a useful diagnostic tool in this setting.

AB - Objectives: To evaluate the yield and safety of transthoracic fine-needle aspiration (FNA) in the diagnosis of pulmonary disease in patients with hematologic malignancy. Design: Retrospective chart review. Setting: Tertiary-care medical center. Patients: Sixty-seven patients with a hematologic malignancy or after bone marrow transplantation (BMT) for a hematologic malignancy who underwent a total of 71 FNAs for diagnosis of an unexplained parenchymal lung lesion from January 1, 1991, to June 30, 1999. Results: The underlying malignancy was lymphoma in 42 patients (63%), leukemia in 8 patients (12%), after allogeneic BMT in 12 patients (18%), after autologous BMT in 3 patients (4%), and other diseases in 2 patients. Radiographs showed focal abnormalities in all cases, and were nodules in 37%, masses in 37%, focal infiltrates in 21%, and cavitary lesions in 5%. The yield of FNA for a finding specific infection or cancer was 56% (40 of 71 FNAs). The FNA with inflammatory changes was clinically sufficient in another 11 patients for a total yield of 72% (51 of 71 FNAs). The yield for lung cancer was 90% (9 of 10 FNAs), for pulmonary lymphoma was 68% (21 of 31 FNAs), and for infection was 67% (10 of 15 FNAs). Complications occurred in 18 of 71 FNAs (25%), with pneumothorax in 14 patients (20%) and chest tube placement required in 4 patients (6%). Bleeding occurred in six patients (8%), including one death in a patient with abnormal hematologic parameters. Conclusion: Transthoracic FNA in patients with hematologic malignancy and focal lung lesions has an excellent yield for detecting cancer and a yield comparable to bronchoscopy for the diagnosis of infections. It should be considered a useful diagnostic tool in this setting.

KW - Fine-needle lung aspirate

KW - Immunocompromised patient

KW - Invasive radiology

KW - Lung cancer

KW - Transthoracic needle aspiration

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