Percutaneous transthoracic needle biopsies in the rapid diagnosis of pulmonary tuberculosis.

From May, 1987, to December, 1990, 173 percutaneous transthoracic needle biopsies (PTNB) using a 19-gauge spinal needle under uniplane fluoroscopic guidance were performed in 160 patients. Thirty-one patients had a final diagnosis of pulmonary tuberculosis. These patients with tuberculosis underwent a total of 35 biopsies. Twenty of 35 (57%) had definite histologic features of tuberculosis with stainable acid-fast bacilli, 4/35 (11.5%) had granulomatous or caseous lesion consistent with tuberculosis, and 11/35 had nonspecific inflammatory changes. When results were matched with the sputum culture results, 15/35 specimens (43%) provided the exclusive means of diagnosis of tuberculosis. Five of 35 (14%) patients developed postbiopsy pneumothoraces. The overall acceptance by patients was good. This report indicates the potential usefulness of PTNB in the rapid diagnosis of selected cases of suspected pulmonary tuberculosis. The yield was comparable to fiberoptic bronchoscopy, currently commonly used in the diagnosis of pulmonary mycobacterial disease. The procedure was noted for its simplicity.