CT guided percutaneous needle aspiration biopsy (author's transl)]

Technical aspects of CT guided fine needle biopsy are discussed. Since CT enables the topographic-anatomical localization of even small mass lesions, the success rate of CT guided biopsy may be considerably high. The diagnostic potential of the method for the biopsy of various organs is discussed.     

Ultrasonically guided percutaneous needle aspiration biopsies (author's transl)]

Ultrasonically guided percutaneous fine needle aspiration biopsies were carried out in 179 patients with sonographically proven space occupying lesions of the liver, pancreas and kidneys as well as the retroperitoneal space. The fine needle aspiration biopsies were done using a B-scan-aspiration-biopsy transducer with a special needle having an outer diameter of 0,4--0,6 mm. Liver metastases were proven cytologically in 57/70 patients (81%), pancreatic carcinomas in 20/31 patients (64%), kidney tumours in 15/20 patients (75%), retroperitoneal lymph node metastases and primary malignant lymphomas in 20/32 patients (62%). The ultrasonically guided fine needle aspiration biopsy is simple, practically without pain, risk or complications for the patient, and is an economically feasible examination method.     

Technique and results of percutaneous transthoracal fine-needle biopsy of lung lesions (author's transl)]

Find needle biopsy of tumours of the lung and mediastinum represents an accurate method which can be performed pain-free and rapidly without undue effort and cost. It can be repeated at any desired time. Absolute contraindications are very rare. This method can be applied also in outpatients, provided certain precautions are observed. In many cases, it eliminates the far greater risk of exploratory thoracotomy. Both peripheral and central lung tumours, including mediastinal tumours, can be identified and differentiated. More than nine out of ten bronchial carcinomas are clearly identified. In 60--70% of all punctures, the pathologist is successful in accurately establishing the type of cell involved. As far as the patient himself is concerned, the method hardly involves any pain and does not cause much discomfort. A frequent complication is the usually asymptomatic pneumothorax, which occurs in less than 30% of all punctures. In a few rare cases, suction drainage will be necessary. Generally speaking, and in all other respects, fine needle biopsy is a low-risk procedure.     

Complications of percutaneous transthoracic needle aspiration biopsy.

After 5,300 percutaneous transthoracic needle aspiration biopsy procedures in 2,726 patients pneumothorax occurred in 27.2 per cent of the patients. Only 7.7 per cent required exsufflation or drainage. The factors influencing the relative frequency and the severity of pneumothorax are discussed. Bleeding around the punctured lesions was found in 11 per cent, and hemoptysis in 2 per cent but were of no clinical importance. In one case evidence of needle track implantation was found. The theoretical and practical importance of tumour cell spread and spread of infection through the needle track is discussed. No air embolism or mortality occurred.     

Punch biopsy or fine needle aspiration biopsy in percutaneous puncture

Purpose: The diagnostic accuracy and rate of complications of CT-guided core biopsies (CB) from suspected tumors of the chest were compared to the accuracy a complications of fine-needle aspiration biopsies (FNAB). Methods: The accuracy in the diagnosis of a benign or malignant lesion of 79 FNAB (19.5 G self-aspirating cutting needle) and of 83 CB (18 G automated core biopsy) and the rates of pneumothorax, pleural drainage and hemoptysis were retrospectively evaluated. Results: With FNAB, the sensitivity for malignant lesions was 62.1 % and the accuracy 68.4 %. With CB the sensitivity amounted to 85.9 % and accuracy to 86.7 %. The rate of pneumothorax was 25.3 % following FNAB, with a drainage rate of 5.1 % compared to 19.3 % and 6.0 %, respectively, following CB. The rate of pneumothorax and drainage increased with increasing path length through aerated lung. In advanced emphysema, the pneumothorax rate did not increase; however, in pneumothoraces, pleural drainage was mandatory in 20 % of FNAB and in 100 % of CB. Hemoptysis without any therapeutic consequences occurred in 3.8 % following FNAB and in 6.0 % following CB. Conclusions: With CB diagnostic accuracy can be clearly increased without an obvious increase in the complication rate. However, in patients with obvious emphysema, the pleural drainage rate of pneumothorax may be higher following CB.      

X-ray morphology of osteodystrophia deformans Paget (author's transl)]

Osteodystrophia deformans Paget is a frequent and localised disease of the skeleton in elderly persons. The x-ray morphology of the disease is not uniform. It depends on the site at the skeleton, on the design of the affected bone, and on the stage and course of the disease. Basing on 71 own observations, the various types of manifestation are discussed and both their characteristic and non-typical pattern explained. Attention is drawn to the complications which can result from involvement of the individual parts of the skeleton.     

X-ray diagnosis of interstitial lung disease (author's transl)]

Characteristic signs of interstitial lung disease can be identified by analysis of roentgenographic patterns of lung structure. Intralobular changes are visible only due to summation effects whereas extralobular changes render direct visibility. Different interstitial diseases show roentgenographic patterns which often become more marked during follow-up films.     

B超定位肝穿刺活检的临床应用

目的对慢性肝炎患者进行B型超声检查,并在B超定位下肝穿刺活检作组织病理学诊断,以明确肝脏的炎症活动分级与肝纤维化程度分期。方法对84例慢性肝炎患者进行超声检查,采取B超定位,组织切割针获取标本,送病理组织学检查。结果84例超声诊断轻度肝损伤53例,中度肝损伤18例,可疑肝硬化8例,肝硬化5例。组织病理学诊断:轻度慢性肝炎39例,中度慢性肝炎26例,早期肝硬化12例,肝硬化7例。结论通过超声定位肝穿刺活检作组织病理学诊断,可了解慢性肝炎的病理分级分期,从而指导临床治疗。     

Ultrasonically guided percutaneous fine needle aspiration biopsy of solid masses

Fine needle aspiration biopsy is a highly accurate cytologic technique in the differentiation of benign vs. malignant disease. After careful localization with the ultrasound beam, a 22 gauge 0.6 mm needle is used to obtain four to five cell samples. Seventy percutaneous fine needle aspiration biopsies were performed nodes, subcutaneous nodules, and other retroperitoneal masses. Ninety-three percent accuracy was obtained with no complications. Studies in four patients with carcinoma of the tail of the pancreas were falsely negative for malignant cells; all four patients had desmoplastic tumors. Complications of hemorrhage, tumor seeding, infection, fistula formation, and pain encountered with other methods and using larger bore needles have not been found with the fine needle technique. It is a safe, accurate method that can be performed as an out-patient procedure.