CT-GUIDED LARGE-BORE CUTTING BIOPSY OF DIFFUSE INTERSTITIAL OR ALVEOLAR LUNG-DISEASE

Twenty-three patients underwent CT-guided large-bore biopsy of diffuse lung disease of clinically and radiologically indeterminate etiology. The procedure was preceded by negative transbronchial biopsy in 20 cases. CT-guided biopsies were performed with a 14-gauge Trucut-needle. Obtaining at least 3 specimens of different parts of the diseased area, a correct histologic diagnosis was achieved in all cases. The size of the histologic specimens [mean: 5-6 mm] exceeded that of the specimens obtained by transbronchial bopsy as reported in the literature. Two major complications occurred and included a rapidly developing tension pneumothorax treated by a small-bore catheter and one self-limited hemoptysis. Major advantages of percutaneous CT-guided biopsy are the nonsuperimposed and very sensitive imaging of lung alterations in diffuse lung diseases that allows evidence of adjacent less and more involved areas accessible by one biopsy approach. CT-guided large-bore biopsy with a cutting needle seems to be a very promising, accurate method in the pathomorphologic work-up of diffuse lung diseases rendering open biopsy unnecessary in many cases.