Study objective: To detect the significance of repeated
ultrasonically guided needle biopsy (UGNB) for the diagnosis of nodular
lesions ≤ 2 cm in diameter.
study to evaluate the diagnostic yield of UGNB.
Setting: University hospital, outpatients, and inpatients
of the respiratory department. Patients: One hundred seven cases
with small nodular lesions ≤ 2 cm in diameter in contact with the
pleura. Sixty-two of 107 cases were malignant, and the others were
Results: Initial UGNB identified 56%
(35/62) of the malignant lesions and 16% (7/45) of the benign lesions,
ie, 39% (42/107) of the total. In 35 of 65 cases that
were not diagnosed by the initial UGNB, it was repeated. Diagnostic
yields of the second UGNB were 68% (13/19) of the malignant cases,
25% (4/16) of the benign cases, yielding a total of 49% (17/35) in
those reexamined. Furthermore, 51 of 65 patients with negative findings
on the initial UGNB underwent fiberoptic bronchoscopy. The resulting
diagnostic yields were 22% (5/23) from the malignant lesions and 18%
(5/28) from the benign lesions, 20% (10/51) in total. Thus, among the
malignant cases, the repetition of UGNB increased the definitive
diagnostic yield from 56% (the initial UGNB) to 77%. In these small
tumors, no serious complications were caused by the procedure.
Conclusions: UGNB should be performed twice for a
definitive diagnosis of small subpleural nodules before deciding on
surgical biopsy or follow-up.