Transthoracic needle biopsy in neoplastic and nonneoplastic pathology: experience in a general hospital.

Transthoracic needle biopsy (TNB) was performed in 344 cases of intrathoracic pathology. In 60 of them, the material obtained was inadequate. In the remaining 284, the possibilities of TNB to identify malignant cells were evaluated. Of them, 202 had neoplastic lesions and 82 had nonneoplastic processes. Among the neoplastic cases, malignant cells were found in 188, (true positive), and in 14 the results were false negative. In the group of nonneoplastic processes, there were 80 without malignant cells (true negative), and two were diagnosed as malignant, (false positive). In these 284 cases with cytologic diagnosis, the global sensitivity was 0.93, and the specificity was 0.97; however, including all cases and the inadequate samples as false negatives, the sensitivity is lower--0.71. TNB required some skill, the use of fine needles, and the collaboration of an expert cytopathologist. TNB is an important method with which to explore intrathoracic pathology.