Diagnostic Aspects of Fine Needle Aspiration for Lung Lesions: Series of 245 Cases


Background: Transthoracic fine needle aspiration (FNA) is one of several methods for establishing tissuediagnosis of lung lesions. Other tissue or cell sources for diagnosis include sputum, endobronchial biopsy, washingand brushing, endobronchial FNA, transthoracic core needle biopsy, biopsy from thoracoscopy or thoracotomy.The purpose of this study was to compare the sensitivity and specificity of FNA and other diagnostic tests indiagnosing lung lesions. Materials and
Methods: The population included all patients undergoing FNA for lunglesions at Meir Medical Center from 2006 through 2010. Information regarding additional tissue tests was derivedfrom the electronic archives of the Department of Pathology, patient records and files from the Department ofOncology. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculatedfor each test.
Results: FNA was carried out in 245 patients. Malignant tumors were diagnosed in 190 cases(78%). They included adenocarcinoma (43%), squamous cell carcinoma (15%), non-small cell carcinoma, nototherwise specified (19%), neurondocrine tumors (7%), metastases (9%) and lymphoma (3%). The specificityof FNA for lung neoplasms was 100%; sensitivity and diagnostic accuracy were 87%.
Conclusions: FNA is themost sensitive procedure for establishing tissue diagnoses of lung cancer. Combination with core needle biopsyincreases the sensitivity. Factors related to the lesion (nature, degenerative changes, location) and to performanceof all stages of test affect the ability to establish a diagnosis.