exudates and Thoracic-Neoplasms

Ultrasound guided lung biopsy (USLB) is a minimally invasive diagnostic tool with short examination time and real-time monitoring conducted bedside for accurate diagnosis in order to provide the best treatment. However, it is not widely performed by pulmonologists. We aim to explicate the efficacy and safety of USLB led by pulmonologists. The objective of this study is to assess safety and efficacy of USLB performed by pulmonologists in an outpatient setting.. We retrospectively enrolled patients who underwent the procedure from January 2018 to April 2022. Under real time ultrasound (Hitachi Medical ProSound F37), thoracic lesions adjacent to the chest wall were sampled with a full-core biopsy needle (CT Core Single Action Biopsy Device, 18G × 15 cm, Vigeo, Italy). Chest x-ray was performed 30 minutes post procedure ruling out pneumothorax. Patients were discharged home 1-2 hours post biopsy. Data was analysed using Microsoft Excel 2010 and Statistical Package for Social Science (SPSS) Version 26.. A total of 18 patients (14 males, 4 females) underwent USLB for lung tumours. Biopsies were histologically deemed adequate with an overall diagnostic yield of 77.8% (14/18). A total of 57% were positive for thoracic malignancy (21% squamous cell carcinoma, 21% adenocarcinoma, 15% small cell carcinoma) and another 43% were positive for extra thoracic malignancy (1 hepatocellular carcinoma, 2 DLBCL, 1 Hodgkin's lymphoma, 1 seminoma, 1 thymoma). Four patients had inconclusive results but managed to get positive results from surgical or lymph node biopsy (thymoma and adenocarcinoma). Statistical analysis showed more than two passes are needed to achieve a positive HPE yield (p value<0.05). There were nil complications to all the cases done.. USLB can safely and effectively be performed by trained pulmonologists with excellent accuracy and low complication rate in outpatients.

Topics: Adenocarcinoma; Female; Humans; Image-Guided Biopsy; Lung; Lung Neoplasms; Malaysia; Male; Pulmonologists; Retrospective Studies; Thoracic Neoplasms; Thymoma; Thymus Neoplasms; Tomography, X-Ray Computed; Ultrasonography, Interventional

Thoracic sarcomas (TS) are rare neoplasms that may present with non-specific pulmonary symptoms. Chest radiographs and computed tomography of the thorax are the investigations of choice, while pre-operative minimally invasive biopsies may not be entirely helpful with the diagnosis. The commonly identified variants of thoracic sarcomas include liposarcomas, leiomyosarcomas and synovial sarcomas. Complete excision of the tumour with clear margins remain the sole definite form of management and there is limited role with adjuvant chemotherapy and radiotherapy. In the present case series, we explore our experience with three patients who presented with TS and the management decisions that was made.

Topics: Adult; Humans; Malaysia; Middle Aged; Sarcoma; Thoracic Neoplasms

Topics: Adolescent; Adult; Age Factors; Child; Cysts; Ethnicity; Female; Humans; Malaysia; Male; Middle Aged; Retrospective Studies; Sex Factors; Thoracic Neoplasms