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CT-Guided Fine-Needle Aspiration Cytology of Solitary Pulmonary Nodules : A Prospective, Randomized Study of Immediate Cytologic Evaluation

Luigi Santambrogio; Mario Nosotti; Nadia Bellaviti; Gianni Pavoni; Ferdinando Radice; Valentina Caputo
Author and Funding Information

Affiliations: From the Institute of General and Thoracopulmonary Surgery, University of Milan, IRCCS Policlinico Hospital, Milan, Italy,  From the Institute of Pathology, University of Milan, IRCCS Policlinico Hospital, Milan, Italy

Affiliations: From the Institute of General and Thoracopulmonary Surgery, University of Milan, IRCCS Policlinico Hospital, Milan, Italy,  From the Institute of Pathology, University of Milan, IRCCS Policlinico Hospital, Milan, Italy


1997 by the American College of Chest Physicians


Chest. 1997;112(2):423-425. doi:10.1378/chest.112.2.423
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Abstract

Study objective: To evaluate the immediate cytologic assessment during CT-guided fine-needle aspiration cytology (FNAC) in the diagnosis of operable indeterminate solitary pulmonary nodules (SPNs).

Design: Prospective randomized study.

Patients and methods: Two hundred twenty patients with SPN undergoing CT-guided FNAC were divided into two groups. In the first one (group A, 110 patients), a cytologist assessed the adequacy of the sample obtained immediately, and when the sample was considered inadequate, fine-needle aspiration (FNA) was repeated. In the second group (B, 110 patients), an immediate cytologic examination was not performed, but only a gross assessment by the surgeon. Histologic study of the SPN was possible in 217 cases, whereas three patients were followed up radiologically.

Results: Adequate samples were obtained in 100% of group A and 88% of group B (p<0.001). The diagnostic accuracy was 99% in group A and 81% in group B (p<0.001). Group A required a mean of 1.22 FNAs compared with 1.10 in group B (p=0.015). The rate of pneumothorax in the whole series was 24%, and statistically significant differences between the two groups were not detected.

Conclusions: Immediate cytologic study significantly increased the adequacy and diagnostic accuracy of CT-guided FNAC of indeterminate SPNs without causing a significant increase of complications.


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