Transthoracic needle aspiration biopsy following negative fiberoptic bronchoscopy in solitary pulmonary nodules

Chest. 1988 Jun;93(6):1152-5. doi: 10.1378/chest.93.6.1152.


To evaluate the utility of transthoracic needle aspiration biopsy (TTNAB) following negative fiberoptic bronchoscopy (FOB) in a patient with a solitary pulmonary nodule (SPN), we reviewed the records from 262 patients who had undergone TTNAB over an eight-year period. Fifty-eight patients had a SPN and met the criteria for inclusion in this series. Twenty-five of these (43 percent) were diagnosed by TTNAB; 24 had malignant lesions; one had M tuberculosis. Of the remaining 33 patients, 18 went on to definitive diagnostic procedures (surgery, repeat FOB or TTNAB). Nine of these patients had a malignancy. Fifteen patients were followed long-term; one was diagnosed with carcinoma two years after the initial work-up. Carcinoma was not found in any patient under 40 years of age. A benign lesion was diagnosed by TTNAB in only two patients. We conclude that TTNAB is a valuable procedure in the evaluation of patients with a SPN and negative FOB. While a negative FOB and TTNAB do not assure that the lesion is benign, a complex of variables influences the decision regarding thoracotomy vs careful follow-up.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Biopsy, Needle*
  • Bronchoscopy*
  • Evaluation Studies as Topic
  • Female
  • Fiber Optic Technology
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / etiology
  • Male
  • Middle Aged
  • Smoking / adverse effects
  • Solitary Pulmonary Nodule / diagnosis*
  • Solitary Pulmonary Nodule / etiology