Head and neck cancer patients with pulmonary nodules: value and role of CT-guided transthoracic needle aspiration biopsies

Head Neck. 2003 Nov;25(11):889-94. doi: 10.1002/hed.10303.

Abstract

Background: To evaluate transthoracic needle aspiration biopsies of pulmonary lesions in patients with squamous cell cancer of head and neck.

Methods: Retrospective series of 85 patients with squamous cell cancer of head and neck cancer and pulmonary nodules who underwent CT-guided needle aspiration biopsy.

Results: Diagnostic samples were obtained in 85% of patients. There were 8 benign and 77 malignant lesions. Among the 73 proved cases, 4 were false-negative cases. CT-guided biopsy had an accuracy of 81%, a sensitivity of 94%, and a negative predictive value of 60%. Accuracies were 68% for lesions of 20 mm or smaller and 89% for lesions greater than 20 mm. In a subset of 45 solitary lesions, among 30 positive biopsies, 15 were categorized as primary malignancies, 3 as metastatic, and 12 as indeterminate malignancies.

Conclusions: In head and neck cancer patients, the prevalence of thoracic malignancies is high when a pulmonary lesion is detected. CT-guided biopsy of pulmonary lesion is an accurate procedure. However, a third of positive biopsies were categorized as indeterminate malignancies.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle
  • Carcinoma, Squamous Cell / secondary*
  • Female
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / secondary
  • Male
  • Middle Aged
  • Neoplasms, Second Primary / pathology*
  • Sensitivity and Specificity
  • Solitary Pulmonary Nodule / pathology*
  • Surgery, Computer-Assisted*
  • Tomography, X-Ray Computed*