Chest ACCP Career Connection
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kazerooni, E. A.
Right arrow Articles by Lynch, J. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kazerooni, E. A.
Right arrow Articles by Lynch, J. P.
(Chest. 1996;109:616-619.)
© 1996 American College of Chest Physicians

Transthoracic Needle Aspiration in Patients With Severe Emphysema

A Study of Lung Transplant Candidates

Ella A. Kazerooni MD, FCCP1; Frederick W. Hartker III MS1; Richard I. Whyte MD, FCCP2; Fernando J. Martinez MD, FCCP3; and Joseph P. Lynch MD, FCCP3

1 From the Department of Radiology (Thoracic Division), University of Michigan Medical Center, Ann Arbor
2 From the Deparment of Surgery (Thoracic Division), University of Michigan Medical Center, Ann Arbor
3 From the Department of Internal Medicine (Pulmonary Division), University of Michigan Medical Center, Ann Arbor

Purpose: To describe the risks of transthoracic needle aspiration (TTNA) in a population of patients with severe lung disease: candidates for lung transplantation.

Materials and methods: Eight of 190 patients evaluated for lung transplantation underwent TTNA of nine pulmonary nodules (mean diameter, 14 mm; range, 0.8 to 2.2 cm). We evaluated pneumothorax rate, chest tube rate, duration of placement, and pulmonary function test results.

Results: All patients had emphysema; two had agr1-antitrypsin deficiency. The mean FEV1 of all patients was 0.64 L (22% of predicted; range, 17 to 28%), indicating severe air-flow obstruction. Six patients (75%) developed a pneumothorax. Four patients required a chest tube (50%); three chest tubes were placed emergently on the CT scanner table. Three patients required a second chest tube for persistent air leak. Tubes were in place for 1 to 22 days (mean, 10 days). One patient had chest tubes for 22 days and required intubation.

Conclusion: TTNA in patients with marked emphysema is complicated by a high incidence of pneumothorax, rapid development of tension pneumothorax and chest tube placement. Since nodules in lung transplant candidates may represent bronchogenic carcinoma, serial CT scans to demonstrate lesion stability or growth, or thoracoscopic resection should be considered as an alternate approach to TTNA to avoid the significant morbidity of the procedure in these patients.

Key Words: lung • biopsy • lung neoplasms • diagnosis • lung • transplantation

Submitted on July 11, 1995
Accepted on August 9, 2007




This article has been cited by other articles:


Home page
 ChestHome page
A. Gohari and L. B. Haramati
Complications of CT Scan-Guided Lung Biopsy: Lesion Size and Depth Matter
Chest, September 1, 2004; 126(3): 666 - 668.
[Full Text] [PDF]

Home page
 ChestHome page
T. Yamagami, T. Nakamura, S. Iida, T. Kato, and T. Nishimura
Management of Pneumothorax After Percutaneous CT-Guided Lung Biopsy*
Chest, April 1, 2002; 121(4): 1159 - 1164.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the American College of Chest Physicians.