Superior vena cava syndrome. Rapid histologic diagnosis by ultrasound-guided transthoracic needle aspiration biopsy.

Abstract:

:We prospectively analyzed the diagnostic yield and safety of ultrasound (US)-guided transthoracic needle aspiration biopsy in the histologic diagnosis of 40 patients with superior vena cava (SVC) syndrome. During a 4-yr period, 40 patients with SVC obstruction were admitted to National Taiwan University Hospital. Of these patients 10 had histologic confirmation by sputum cytology (3 patients), fiberoptic bronchoscopy with biopsy (2 patients), or lymph node biopsy (5 patients) at admission. A total of 30 undiagnosed patients underwent real-time ultrasonographic (US) evaluation as well as color Doppler imaging. Patients with tumor detectable by US underwent US-guided transthoracic needle aspiration biopsy. Of the 30 patients who received US chest examination, 29 had widening of the upper mediastinal shadows in the chest radiographs. In 27 patients tumors were detected by chest US. After assessment of collateral vessels by color Doppler US, these 27 patients underwent US-guided transthoracic needle aspiration biopsies; histologic diagnoses were confirmed in 25. The diagnostic yield was 83.3%. The mean duration from admission to histologic diagnosis was 2.1 days. None of the patients developed complications. We conclude that chest US and color Doppler images are useful tools for evaluation of patients with SVC syndrome. US-guided transthoracic needle aspiration biopsy appears to be a safe, effective, and rapid approach for obtaining an accurate histologic diagnosis. Specific treatment can thus be initiated without delay.

authors

Ko JC,Yang PC,Yuan A,Chang DB,Yu CJ,Wu HD,Lee LN,Kuo SH,Luh KT

doi

10.1164/ajrccm.149.3.8118650

subject

Has Abstract

pub_date

1994-03-01 00:00:00

pages

783-7

issue

3 Pt 1

eissn

1073-449X

issn

1535-4970

journal_volume

149

pub_type

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