OBJECTIVE:Distinct aspects can influence the complication rates of computed tomography‐guided percutaneous fine needle aspiration biopsy of lung lesions. The purpose of the current study is to determine the influence of radiological techniques and clinical characteristics in predicting complications from this procedure.SUBJECTS AND METHODS:A retrospective study was developed involving 340 patients who were submitted to a consecutive series of 362 computed tomography‐guided fine needle aspiration biopsies of lung lesions between July 1996 and June 2004, using 22‐gauge needles (CHIBA). Variables such as the radiological characteristics of the lesions, secondary pulmonary radiological findings, co‐morbidities, and aspects concerning the procedure were studied.RESULTS:The diameters of the lung lesions varied from 9 to 140 mm, with a mean of 51.5 ± 24.3 mm and median of 40 mm. The depth of the lesions varied from 10 mm to 130 mm, with a mean of 44 ± 20.9 mm, and median median of 52 mm. Complications occurred in 52 (14.4%) cases, pneumothorax being the most frequent, with 40 (11.1%) cases, followed by hemoptisis with 7 (1.9%) cases, and hematoma with 4 (1.1%) cases. Lesions that did not contact the pleura, with normal pulmonary tissue interposition between lesion and pleura, had higher complication rates, with 22 (22%) cases, than lesions that contact the pleura, with 6 (9%) cases, with a statistically significant difference (p  =  0.03).CONCLUSIONS:CT‐guided percutaneous fine needle aspiration biopsy of lung lesions had a lower rate of complications in our study and presented more rates of complications on lesions that lack pleural contact.

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SUMMARYMalignant insulinomas are frequently diagnosed at a late stage. Medical management is necessary to slow progression of the disease and control of hypoglycemic symptoms when cure by surgical treatment is not possible. Multimodal treatment, in these cases, has been used with variable clinical response. We describe a 68-yr-old woman who presented response failure to usual treatment and was alternatively treated with radiolabeled metaiodobenzylguanidine ([

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OBJETIVO: O objetivo deste estudo é apresentar a experiência de um centro oncológico com o procedimento de biópsia por agulha grossa de lesões pulmonares guiadas por tomografia computadorizada. MATERIAIS E MÉTODOS: Trata-se de um estudo retrospectivo de 97 biópsias por agulha grossa de lesões pulmonares guiadas por tomografia computadorizada em um centro oncológico, referência no Brasil (Hospital do Câncer - A.C. Camargo), entre os anos de 1996 e 2004. As informações a respeito de material adequado e diagnóstico específico foram coletadas e analisadas. RESULTADOS: Das 97 biópsias pulmonares, 94 (96,9%) forneceram material suficiente para análise histológica, e destas, 71 (73,2%) corresponderam a lesões malignas e 23 (23,7%) corresponderam a lesões benignas. Em três biópsias o material obtido não foi suficiente para análise. A frequência de diagnóstico específico foi de 83 (85,6%) casos, demonstrando elevadas taxas, tanto nas lesões malignas, com 63 (88,7%) casos, como nas lesões benignas, com 20 (86,7%) casos. Considerando as complicações, ocorreram 12 (12,4%) casos no total, divididos em 7 (7,2%) casos de hematoma, 3 (3,1%) casos de pneumotórax e 2 (2,1%) casos de hemoptise. CONCLUSÃO: A biópsia percutânea com agulha grossa de lesões pulmonares guiada por tomografia computadorizada demonstrou elevadas taxas de material adequado e diagnóstico específico e reduzidas taxas de complicações no presente estudo.

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