Yield of ultrasound guided transthoracic needle aspiration in peripheral intrathoracic mass lesions

Background: In thoracic lesions, early diagnosis and sorting out into malignant- benign is important regarding the therapeutic decisions and prognosis. Ultrasound guided Transthoracic needle aspiration (TTNA) and Corebiopsy (CNB) are described to be safe accurate high yielding means of diagnosis. The study aims to determine the yield and safety of TTNA in peripheral intrathoracic mass lesions. Materials and Methods: Study was conducted in government teaching institution in Kerala. Patients with intrathoracic peripheral mass lesions which were visualized by USG were subjected to TTNA, and sent for cytopathology. The patients with inconclusive results were subjected to either USG guided or CT guided CNB. The patients were followed up till a conclusive diagnosis obtained. The results were classified as conclusive /definitive or inconclusive. Diagnostic yield and complication rate calculated. Results: USG guided TTNA had an overall diagnostic yield of 65.5%,with 72.15% yield in malignancy. It had high diagnostic yield in lung carcinoma (82.3%) and was a safe procedure with complication rate of 3% only. Combined with USG guided CNB, the overall yield became 86.66% with a cumulative yield of 91.13% in malignancy with no increase in complication rate. Conclusions: Ultrasound guided TTNA is a safe procedure with good yield in peripheral lung malignancies. Ultrasound guided transthoracic needle aspiration and core cut together has a high diagnostic yield in peripheral intrathoracic masses and is accurate in differentiating malignant and benign lesion with a good safety profile. Keywords: Core-needle Biopsy (CNB), Computed tomography ((CT), Transthoracic needle aspiration (TTNA)), Ultrasound (USG).