Percutaneous aspiration lung biopsy.

A total of 182 percutaneous trans-thoracic aspiration biopsies were performed in 164 patients over a three-year period. In malignant neoplasms arising in the lung the diagnostic accuracy rate was 84%. In the non-malignant localized parenchymal lesions the accuracy drops considerably unless the lesion is cystic or cavitary. Some patients with non-parenchymal lesions were selected to assess further the value of this procedure. It proved much less rewarding in lesions of the chest wall, diaphragm and also in diffuse parenchymal disease. These lesions may be more accurately identified by other methods of biopsy. Lesions presenting as a mediastinal mass are an intermediate group and in selected cases helpful information can often be obtained by small-bore needle aspiration, particularly if a pericardial, bronchogenic or thymic cyst is suspected. Recent reports have shown that the aspiration of pulmonary lesions can be utilized to obtain viable tumour cells for chemosensitivity testing. The aspiration of nodular pulmonary lesions should be considered when a diagnosis is not forthcoming from the usual investigative means, since there has been little morbidity and no mortality in the series.