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Diagnostic accuracy and adequacy of peripheral pulmonary nodules samples obtained by transthoracic needle aspiration

Cytopathology. 2022 Sep 5. doi: 10.1111/cyt.13176. Online ahead of print.


OBJECTIVE: The objectives of our study were to examine the adequacy of samples and accuracy of transthoracic needle aspiration (TTNA) in patients with peripheral pulmonary nodule (PPN) diagnosis.

METHODS: The retrospective study included 248 patients who underwent TTNA of PPN and subsequent diagnostic-therapeutic surgical procedure during a 5-year period. The material was processed at the Department of Pathology and Molecular Diagnostics. The following were analyzed: adequacy of cytological samples for diagnosis and molecular testing, tumor localization and dimensions, and its cytological and histopathological characteristics.

RESULTS: The adequacy of the cytological samples was 93.15%. The proportion of adequate-diagnostic samples was higher in patients in whom the largest diameter of the lesion was >4cm, and this difference shows statistical significance. Tumor localization wasn’t a statistically significant factor for the adequacy of samples for cytological analysis. Cytological samples of lung adenocarcinoma had high projected adequacy for EGFR analyses of 91.55%, and it doesn’t depend on the size and location of the lesion. The most commonly diagnosed lung tumor was adenocarcinoma (45.51%). Patients with cytological diagnosis of NSCLS-NOS, after histopathological analyses, had adenocarcinoma in most cases (53.85%). The overall accuracy of TTNA in the diagnosis of PPN was 71%. The method’s accuracy was 75.24% for malignant tumors, while it was 28.57% for benign tumors. The accuracy of cytological analysis for the histological type of tumor was 84.18%.

CONCLUSION: TTNA with cytological analysis is an effective and highly sensitive method in determining the etiology of PPN.

PMID:36062401 | DOI:10.1111/cyt.13176

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